Should I Consent to a CAF on my DS?

[GirlInASwirl]

Hi All,

I have had a discussion with my DS's school nurse today. For the first time a possible CAF (Common Assessment Framework) was mentioned - albeit in passing.

My Ds (13 yrs) has had bullying issues for a number of years and this has dented his self-esteem and exacerbated an underlying disposition towards anxiety/depression (family trait). In the last few months, cyber bullying (which has been show to/been dealt with by the school) has led to a first incidence of self harm. Since the incidence; I have found my DS a young carer's worker who he can offload onto (my partner has a form of Autism). DS seemed to be on the mend and had reported to this new worker that he was "nine-and-a-half out of ten" in terms of happiness at the moment.

I have a background in teaching, working in children's homes with young people with emotional and behavioural difficulties etc, counselling, child protection (and so forth). I have always been upfront in discussing any issues and getting support for my son as needed. I have decided that an assessment from CAMHS would be helpful as he is now more of an age to engage in any treatments. I am off to the GPs to ask for that tomorrow.

I feel that I am capable of asking for the help that my DS needs without the (unnecessary) intrusion/judgement of other professionals. Like many in my position; I am more comfortable asking specifically for what is needed - rather than having an all-encompassing discussion of everything at home. I don't want to feel patronised.

If you were in my position; would you consent to the CAF?

Looking for opinions whether or not you have experienced one with your children.

Thanks

As someone who has a very similar career background to you- no I wouldn't agree to a CAF. Simply because I know how professionals can be & it's easier to not be emotive when it's a child you're charged with rather than your child

Good luck to you & your DS.

A CAF is a double edge sword. We had CAMHS suggest a CAF when Ds refused to engage but Ds' school is against it. A CAF has the advantage of getting everyone to recongise the child needs help. A CAF can help when there are more than one child in the family. Ie. If you have a young child witnessing violent outbursts and CAHMs are doing nothing. There is a stigma.

I think that if a child has mental health issues then a holistic discussion of the child's environment can be helpful. As embrassing ad it might be I think it's reasonable to look at what is happening at home if a child is self harming.

In some areas you need a caf in order to get a camhs referral (you do where I live). You also need a cad where o love to get a referral to the young carers service. I don't know the procedures where you live but a caf where I live doesn't necessarily mean lots of professionals being involved it can simply mean a teacher doing a caf and registering it in order to make a referral to a single service. I have been a social worker and also a service user due to disability in the family and one of my children uses the young carer services and therefore has a caf. We
Don't have anyone else involved except the young carer service. Whether you should get a caf depends really on how your area works in regard to cafs and referrals.

Thank you for that LifeLong. Yes there is a big distinction between being a 'practitioner' and 'parent' to a child. I don't think I want my DS being discussed impersonally round a table - like a 'case'. There is also a feeling that I have somehow failed if I can't coordinate what he needs myself.

I wonder what parents did before the introduction of CAF? (tongue in cheek!)

ReallyTired - It is difficult if you have been able to get a CAMHS referral and (for whatever reason) your child is not ready to engage. That's a really tough one for any parent to absorb. All you can do is try your best and put in some protective strategies to evade the worst. Very frustrating.

As far as discussion of home environment. There is an extended family history of depression (my Mum, Dad, younger bro) and I kinda knew that we were to expect something at some stage. I have trying to educate DS on strategies to overcome where he is at. We talk for at least an hour each evening on where he is up to. In the case of his self-harm; kids from school contacted him on facebook messenger - there was graphic bullying related to his eczema/medical conditions followed by suggestions that he 'drink bleach' and visit sites that promote suicidal ideation. Obviously; I was horrified and took the whole message into school. Up to that point he was down but nothing we could not bounce back from as a family. I think he is just at a stage where he can't be bullied anymore. And for my own piece of mind - some mental health input/diagnosis would help it not to progress further.

I think it is a common assumption that there must be something 'very wrong' at home if a child is self harming. And yes there should be some reassurance that parents are proactively helping their kids with mental health issues. There are also some extremely good parents that just happen to have children with extra/unusual needs that want an extra layer of support - rather than a take over posse.

Thank you for that Six - I hadn't thought of regional variations in CAF procedure (My CAF knowledge is about 10 years old). I was able to refer to the local young carer's project myself. I think (but I'm not actually sure as yet) that a CAMHS referral is just a GP thing here in the NW.

I think I need to ask the school why they think a CAF would be useful and who they would want there.

A CAF is a lot of work for the school. They wouldn't do it lightly.

Why are you so defensive about discussing your son's home environment? I don't think does parents any harm to reflect on what at home might be improved. A child with issues needs outstanding parenting rather than good parenting. Achieving outstandingly good parenting is hard.

Yes a GP can make a CAMHS referral, but getting CAHMs to offer meaningful help is a challenge. Ie. Some idiot pen pusher will refer a child who is hearing voices to an online CBT site given half a chance. A CAF shows that everyone is concerned about the child and you aren't just an over anxious mother.

girlinaswirl it depends where abouts in the NW you are. Having worked in 2 different areas in the NW they have very different caf procedures. One of the areas is CAF for most things and the other is caf just got cases where they need multi agency involvement and regular CIN / TAC meetings. There is another NW region that I am aware of where you can self refer to some services and the GP can refer you to camhs but if camhs then decide on a referral to the ASD side of camhs for assessment they need a caf and a lengthy form filling in by school. It's a minefield. I don't know why all areas can't just be the same.

And I totally agree with what reallytired has written. A caf is nothing to be afraid of / ashamed of. A caf can lead to the child's needs being better understood and the child getting appropriate help. Where there are no parenting concerns a CAF can be a really useful key to accessing appropriate and helpful services.

I think you're right OP in asking whom would attend the meeting. I know if I was in your position there would be people who I would not have there. Not in a month on Sundays. Not when he'll had frozen over. Because I know how amazingly shit poorly they practice. And by that I mean individuals not professions just to clarify

Thanks for the ongoing thread.

This morning I spoken with DS's G.P at 7.30am and was into see her at 08:10! She has agreed to write CAMHS referral letter today. We are checking in with her again on Friday afternoon - so that she can speak to DS face-to- face about his needs and so that he understands the next stages.

I have also been in to see the leader of the Young Carer's team (here he already gets support)and they have agreed to assign him a new worker (who is more experienced and available during this period.

I asked for their opinion on the CAF process locally and their suggestions are that I make recommendations who would be the most appropriate lead professional, plus ask to be carbon-copied into all professional e-mails. If the CAF is not delivered on; I can pull with a written explanation of why it is not working for us (rather than it looking that we are non-engaging). I have decided to get up to date on the CAF process in the local areas that we sit on the border between and what our rights are as parents.

Once I have been through this process I would be in a much better position to make an informed decision.

A question was raised above about 'defensiveness'. There are mental health issues in the family (particularly in relation to my brother). My mum has been fighting for the last nearly 20 years to get the right help from various agencies (CAMHS being one) to no real effectiveness. I have been her rock to lean on when he has been in hospital or suicidal (again) - I could write a book on it all! I don't want the situation with my son to go the same way - where everyone appears to be listening - but nothing gets done. Mind you - I am also a bit more forthright about what is needed.

For me I wouldn't agree to a CAF purely because from what I have seen with friends it has been an exercise in shifting the blame for the school's failings onto the parents rather than putting in any meaningful support or strategies into school for the child.
So a child bullied mercilessly at a school seemingly unable or unwilling to address the bullying had their homelife investigated for "underlying reasons for low self esteem and anxiety" Pretty sure that the child's self esteem would have been higher and anxiety levels would have been lower if the school addressed the bullying tbh.
After much paperwork, many meetings there was no support offered for the child in school and there was much more stress for the parents who eventually decided to move the child from the school which funnily enough helped no end with the anxiety and self esteem difficulties.

We found it helpful because it enabled more communication between CAMHS and the school. Not that anyone from CAMHS ever attended a single meeting despite being invited to them all.

It did mean that CAMHS started accepting direct calls from the deputy head teacher, and taking on board what the school said.

I find your attitude quite defensive and you seem to be working very hard to justify not agreeing to it. For the benefit of your son, it would be helpful for someone with a fresh pair of eyes to look at things.

JoJo, I think the op is scared rather than defensive. It's horrible to admit that you cannot solve all your child's problems. As a parent (rather than a professional) it's impossible to depersonalise the situation.

Maybe the OP feels an unwarranted sense of shame.

Sorry if I came across lacking in empathy - I do realise it must mega hard to be in that situation ;(

Sorry not been on for a while - poorly with virus passing around local gym.

CAF has not been mentioned again by anyone - so reason for post have become somewhat redundant.

But to answer a few points....when you go to a counsellor you get time to build up a trust and rapport before divulging problems associated with mental health. Because of the ethical practices of counselling (beneficience, non maleficience etc); I trust that my son would get benefit from this type of relationship. He is comfortable being one to one with people.

If a CAF would be called; apart from the Carer's service - we would have no knowledge of the calliber of the practitioners attending, their motivation to deliver or if they are experienced/professional enough to get things done. How appropriate would it be to talk at an intensive level about problems with complete strangers? It would surely be natural to feel 'defensive' in that situation....Like another poster said; when you have been a practitioner you know that there are those that see work as 'just a job' and ones who have a deeper empathy for those they support.

At the moment; I am able to introduce good practitioners to my DS one by one - after there has been some vetting/relationship building beforehand. I know which workers would be a 'natural fit' with my DS's character and would get support (gently) in place without being over-facing for him.

Quality of practitioner, rather than quantity. CAF meetings would feel too impersonal and corporate for our needs. That's my personal stand

Caf meetings do feel horribly impersonal

I refused one in the early stages of my dd's MH issues because I didn't have the benefit of professional experience and didn't really understand what it was

As her condition deteriorated I've had it thrown back in my face, it's on lots of documents 'mum refused caf intervention which prevented early intervention'

It did no such thing, dd was already seeing Camhs before a caf was mentioned

The school could have and should have made adjustments without a caf being in place but chose not to

You make a good set of points Emo - I also would not feel confident providing consent for CAF if the process was not clearly defined beforehand.

There are two things which concern me about your post - a.) that your DD seemingly got worse under CAMHS intervention and b.) that professionals have use CAF as a stick to beat you with.

Professionals should not need a CAF to be able to change pace/direction if symptoms persist/deteriorate. Too many 'jobsworths' and not enough proactive care? I can only imagine how frustrating that would be.

Dd got worse because the school did not recognise and remedy the issues that were affecting dd's mental health

I actually cannot fault Camhs and they have acted as an advocate for dd at a number of meetings including her ehcp meeting

Every empathy Emo - yes; we are struggling to get the school to recognise the damage that bullying can have. I find that even the brightest schools can be in denial about what is going on within their walls. Any 'low level' bullying that is persistent can seriously affect a child's mental health. We have had little practical help until DS was at crisis point and a full log of evidence is under the school's nose. Was the problem with your DD related to bullying? (please feel free not to answer if it's uncomfortable)

Sounds like the help from CAMHS has been really supportive. I hope that I can get that same level of advocacy from our local service. We've met CAMHS worker for the first time today - she seems very understanding and proactive

Not so much bullying but more unwanted sexual attention which went from inappropriate comments to physical touching

School was made aware of the comments, 'dealt' with it but then didn't communicate to the next year group when they moved up so dd was repeatedly put in situations where she was sitting next to him, working with him in drama etc

She spoke up previously and it didn't fix things so she didn't speak up again

I rang school repeatedly saying something is wrong, she's having panic attacks, lots of stomach aches, migraines, she's having mood things and socially isolating herself -school couldn't see it or put it down to being a year 8 girl!

They only sat up and took notice once dd refused to go to school at all but it was too late by then

She now has a diagnosis of aspergers, anxiety and PTSD