Words and Pictures
• See Chapter 5 in
A.Turnell and S.Essex
Working with “Denied” child abuse: the
Resolutions approach. OU press 2006
• And article in Context 97 June 2008
• Hiles, Essex, Fox and Luger.
Susie Essex Oct ober 2011
Resolutions words and pictures
Helping to create a coherent narrative about difficult
• What would you like me to make sure I
cover this morning?
Basic Principles and Techniques.
Brief exercise.
Recent experiences.
Susie Essex Oct ober 2011
Entertaining multiple positions simultaneously,
Process leading up to Words and Pics very important. See book Donna’s case
Chapter 4.
He did it
Mother: He’s my
Husband, I don’t
know what to think
Dad: You’re sick people
Out to destroy me
I’m confused
and worried
She should
leave him!
Like these jugglers you need
to be able to utilise and keep
all the positions ‘in play’
all the time
The challenge is
this often feels
like you’re
juggling fire
The Benefit of the Words and Pictures Process
“Some adults who, despite having had very traumatic childhoods
about which they can nevertheless tell coherent stories, are likely
to have securely attached children…………
One important therapeutic implication of this finding is that
it may be helpful, perhaps even transforming, to help the family
to tell a more coherent story about its painful experiences,
Including (traumatic events) its illnesses.”
John Byng-Hall
“Toward a coherent story about illness and loss.”
in Multiple Voices 1997.
‘Certain topics are so emotionally laden that
some people seem to think that systemic
ideas do not apply in such cases....’
Cecchin, Lane and Ray Irreverence 1992
We can be over or under organised by topics that
emotionally overwhelm, how do we find a way that
includes children and children’s voices.
Susie Essex Oct ober 2011
This light globe seems faulty
A key issue in Child Protection is how do we
create openess about the concerns.
This light globe
Still seems faulty…
…but now we’ve
a whole new
lighting system!
No Gratuitous opinions
• Could we leave whether you did it or not to one side, up on a shelf
so to speak?
• If the dispute was easy to resolve I guess it would have happened
by now.
• Current research indicates, I can understand from the research and
literature why they are worried but i do hear what you are saying , I
have made a note of it here.
• Don’t be tempted to give a definitive position.
Susie Essex Oct ober 2011
Words and Pictures
Explanations for children as to what has
happened in their family and why they may not
be living at home, using drawing, play people
Undertaken with children and their parents and
often with members of the support network
Words and Pictures are the bedrock in creating
openess which leads the way to an agreed
safety plan.
Susie Essex Oct ober 2011
DVD Case Example
Alex and Kate Smith have two children, Jake 4 years
and Chloe 8 months. Chloe is presented at hospital
having allegedly been dropped by Alex whilst in his sole
care. Medical examination reveals linear bruising to
Chloe’s cheek, rib fractures of different ages and
subdural haematomas, which the doctors think are nonaccidental in origin. The family are not known to Social
Services and the Health Visitor reports positively about
the parenting and care of the children until this time.
Jake is placed in foster care and Chloe joins him when
she is allowed to leave hospital. Alex and Kate are
allowed contact with the children five days per week
supervised by social workers. The matter is put before
the Court which has to decide what should happen to
the children. Further assessments reveal no other
concerns and both parents deny they have injured
Susie Essex Oct ober 2011
Genogram Alex and Kate.
DVD case example Julia and
• A pre-school girl from Sunday School (Kelly),
where Gerry helped as Leader, alleged that
Gerry had sexually abused her. The matter
was not taken to court but Social Services
“substantiated” the allegations based on the
detail of oral abuse in the girl’s report. As a
result of this Social Services were concerned
for the current and future safety of Gerry and
Julia’s 3 year old daughter Emma. Julia’s
sister Sharon and Julia’s mother have been
helpful during the
Susie Essex Oct ober 2011
Julia and Gerry Genogram
Financial Advisor
Artist Community
Social Workers
CSA Allegation
Susie Essex Oct ober 2011
Sunday School
Nursery School
Day Care
Words and Pics exercise
• In threes think of the DVD family with injured
baby Chloe or little Emma.
• What might you expect someone to say to Jake
about why he and his sister were going to Foster
carers for a while?
• What might you expect someone to say to
Emma about why Daddy is not at home?
( Think how you might use age appropriate
language and some pictures)
• Who might explain to Jake/Emma, how might
you help them explain?
Susie Essex Oct ober 2011
Exercise in 3’s
• In 3’s think what you might want children to
know about the concerns.
• What might they already know and how?
• Who would you want to talk to the children
about the concerns, workers, family member?
• What would you want them to say, how much
or how little to get across the concerns?
Susie Essex 2011
Susie Essex Oct ober 2011
It isn’t easy.
• Children are often not asked what they make of what
is happening.
• Children are often left out of discussions about what
is happening and why.
• Adults are often at a loss about how much to say, or
how little to say, and what words to use.
• By adults I include not just family members but also
key professionals.
• If we have ideas about what to say how do we take
family members /carers worries into account.
Susie Essex Oct ober 2011
Fictitious Case Example for
Fabricated or Induced Illness
Family Members
 Mother: Mari 24
 Father: Ralph 32
 Jodie
Dual Heritage 2nd Generation
White UK
born Autumn 2006
age 1 month Apnoea attack
age 6 weeks Apnoea attack and rash
age 3 months rash possible Apnoea
 Previous Child Death
 New Baby Due
The Safety Network
Boy Eli age 10 months in 2005
Easter 2008
dual heritage white UK and black British
Great Uncle Frank and girlfriend Jo (Grandpa died 2005, white UK)
Godmother: Connie
Church friends: Pastor Mark and Cheryl etc….
Susie Essex Oct ober 2011
Words and Pictures for Jodi - 1
In 2006, in the Winter, Jodi had a rash on her face.
The doctor came to see Jodi.
Grandma Sophie was there, as Mum had called her becaus
they were so worried about Jodi.
The doctor gave Mum and Dad a letter, saying ‘Please take Jo
to Hospital.’
Words and Pictures for Jodi - 2
Jodi went to the Hospital. Mummy told them Jodi seemed a bit
in the night. The doctors said ‘The rash might be a virus, but w
need to check.’
Jodi stayed in Hospital.
Words and Pictures for Jodi - 3
The doctors were worried as this was the third time in 3 months
that Jodi had come to Hospital since she was born.
The doctors talked to another doctor…..they thought the rash m
because someone had stopped Jodie breathing but they could
…..then they talked to Social Services and other people.
Words and Pictures for Jodi - 4
There was a big meeting - a Case Conference.
The doctor said ‘We are very worried about Jodi’s rash. We th
been hurt’
The Case Conference decided to ask another doctor
in London to see Jodi.
Words and Pictures for Jodi - 5
In London, Mummy and Daddy said Jodi had one rash and
had been to hospital lots because she was ill.
The doctors seemed to say different things. Everyone was very
The Social Worker said this is confusing and worrying. I have to
Jodi is safe .
We need a Judge to help sort it out.
The Judge said she thought Jodi had been hurt when mummy
after her.
She said she had to be sure Jodi would not be hurt again.
DVD clip Words and Pics
Susie Essex Oct ober 2011
Words and Pictures Process
in outline
• Explain the process to parents and their key advisors.
( Explore these same issues with the other parent, kinship system,
and significant adults in the child’s life)
Offer a first draft of the explanation to parents and
advisors, and if possible network system.
Edit refine and agree the final version with parents
advisors and social services. (CYPS). (Pictures
agreed either what will be drawn or done as part of
the draft.)
Provide the explanation using the words and pics
document to the children preferably with network
Susie Essex Oct ober 2011
Questions for Words and
What do you think Sharni makes of what is
What makes you think she thinks that?
What questions has she asked?
What difference would it make if she knew a bit
more about what has been happening?
What might she have overheard?
What does she think happened to Asha, why
does she think she is staying with grandma?
Susie Essex Oct ober 2011
Words and Pics storyboard
First part
Keep Checking
• 1. Begin by briefing statutory child protection
workers on the process and obtain their permission
and endorsement to undertake the process and
commitment to use the words and pictures within the
looked-after/child protection system .
2. Check with the parent or parents about the problem (e.g.,
mental health problem; severe illness; child protection
concerns; drug or alcohol misuse) regarding from their point of
view what would be most helpful for their children to
understand about the situation.
3. Explore these same issues with the other parent, kinship
system, and significant
adults in the child’s life.26
Susie Essex Oct ober 2011
Second part, First Draft.
• 4. Explore with child/children what they make of what is
happening, what they already think and know, and what they are
concerned about. ( Depending on the circumstances include a
parent, or both parents and a supporter or children’s current
carers/ trusted adult from the kinship system. For teenagers
have a separate session to talk through what would work best
for them.)
• 5. Draft the explanation utilising the families own language and
ways of expressing concerns wherever possible bearing in mind
the family’s race culture and religion. Link all the above to any
worries about the children at home, at school, with peers ie how
the child might be expressing some of the worries and their
Susie Essex Oct ober 2011
Second part cond.
• 5cond.. The explanation should be balanced and not solely
focused on the concerns/ negative. The explanation should be
framed with a neutral or affirmative beginning and a positive
end. The explanation should include meaningful positive events
or aspects of the child’s life that fit and add to the overall story.
• 6. Present the first draft to the parents. Develop and refine the
Words ( and Pictures if drafted), so that they are comfortable
with the draft and the explanation reflects what they have
agreed the child should know.
• 7 Once the parents take ownership of the explanation, the next
task is to ensure that the explanation captures everything the
statutory agency wants the child to know.
Susie Essex Oct ober 2011
Third Part.
Making sure everyone is on the same page
• 8. Provide the explanation to child/children with their
parents, extended family, carers and social service
workers present. Set Context, use traffic lights, think
carefully about teenagers.
• 9. Ensure that all other significant extended family
members and adults in the child’s life have seen the
explanation and will draw upon it when they need to
talk to the child about the problems, their parents
difficulties or why they are in care.
Remember no-one finds it easy to know what to say, or how
much, this document forms the basis of all the work. If
there are new concerns or more positive information comes
to light, this can be added
or included as sessions take
Susie Essex Oct ober 2011
Words and Pics Basic Structure
1. Title to be clear what this is about,
2. Start Pic sets the Context, neutral not too worrying,
3. Who is worried,
4. What are they worried about, clear about what the
worries are this might be the only chance to let
everyone in the system know the concerns,
5. Who is trying to help and move things forward,
6. End all working together. Positive picture and future
susie essex 2011