Aroha in action hui: How can we get the story right?

[Animated graphic: Aroha in Action Family Start Hui 2023 graphic]

[Text on screen: How can we get the story right?, Julie Sach]

[Text on screen: Julie Sach]

Julie Sach:

Kia ora koutou. Ko Julie Sach taku ingoa. I’m the Social Change Manager at Tautoko Mai Sexual Harm Support Services. I’m based in Tauranga, but we operate across the Bay of Plenty and the Waikato. I’ve been in this role for about four years but I have worked in social services for about 35 years across government, NGOs, and probably one of the reasons that I’m doing this presentation is that one of my jobs has been working at the Family Violence Death Review Committee where my job was to request and review all the documentation associated with family violence homicides across the motu. It gave me a real insight into the problems of the way we construct stories and how those stories can be misrepresented or misconstrued or misunderstood. A whole lot of ‘mis-es’ that ended up creating problems for the whānau that we work with, the families, the children, and the systems that we work in. So, I really wanted to talk about this subject with you, really thinking about the way we document things and what happens in that documentation process and really examine that a little bit more.

[Slide on screen: How can we get the story right?]

Because my work has mainly been in family and sexual violence I’m relating it back to this context, and I understand that a lot of your work will be in this space as well.

[Slide on screen: The recording process is complex]

Thinking about how much, the way we record things, is quite a complex endeavour and how we, as practitioners, how we write about, speak about, or construct the problem that’s in front of us, in terms of what we’re trying to address for the family, or how we think about that, determines what happens next. But there’s a lot more complexity than just how we think about it because we’ve got things like how information is stored and presented as part of a process, where an overall story of a case is talked about or written about. So sometimes our storage of information is problematic, and I don’t know about you, but I’ve worked across a Corrections, a Police, an Oranga Tamariki information storing systems and it’s actually not that easy to find stuff. So, we need to think about how our systems store our information to make it retrievable and useful to ourselves as workers. And that’s a systemic issue, that’s a bigger issue.

The next step is when we, as record writers, make both intentional and unintentional selections of what to filter out or include in the records. So, we don’t just write everything that happens we pick out particular things that we want to write about. I guess what we want to be thinking about is being intentional about what we put in, and thinking about the things we leave out, and there’s plenty of cases where social workers, practitioners, family workers, left out critical information that would have made a difference in terms of understanding what was going on for the people involved in the case they were working. So, thinking about what do we put in and what do we leave out, so we’ll talk a little bit about that as we go along.

And, lastly, this is quite flash words, but the linguistics and the words we use and the way and what we choose to put in shapes what happens for the people that we’re writing about, and I guess that’s the longevity of it. Case notes can go on for a very long time, they can follow people around, they can last for a very, very long time so they’re critical. And when we look back now on records that have been written years ago and we notice the difference in the way that it’s been languaged in the past and think, ‘Oh, we wouldn’t write it quite like that now.’ Because things evolve and we change, and we think about what we’re recording. But those stories can stay with those families for a long time and sometimes that can be helpful and sometimes that can be detrimental, particularly if we haven’t got the story quite accurate, so we’ll talk about that in a minute.

[Slide on screen: Examples]

This is just an example of what I’m talking about. So, in the first example, the worker calls the person that I’m calling the victim, so the person who has been subjected to violence. They call that person three times and they get no answer. And the interpretation on that for that worker was, ‘she doesn’t want or need our help because she’s not taking our calls.’ So, the case note read something around, ‘She has disengaged with our service, she is safe with whānau, she will contact us if she needs us.’ And so, then that case note informs the action that comes after that, which is that the worker decided to close the file.

Whereas an alternative account might be the same event, ‘I call the victim three times and get no answer,’ but the interpretation might be different, ‘I don’t know what is happening with this case. This person was quite high risk when I spoke to them, so who else can I talk to?’ might be a question that might be asked. And the case note reads something like, ‘This is a very unsafe situation and I’m very concerned for this person’s welfare.’ Which informs the action that follows next, which instead of closing the file, becomes calling the police and discussing concerns and then making other decisions to call a cousin to see if I can find this person who I can’t contact.

So, you can see that the interpretation of the event by the worker dictates what they then record and then what actions follow from that.

[Slide on screen: Information shared ≠ information understood]

So, what we’re saying is that the information that we share doesn’t necessarily equal the information that’s understood. So, when you’re working in family violence the potential to prevent further family violence by information sharing is reliant on the integrity of the information that’s sought, so what we’re asking, what we need to know from who. So, if I say to Oranga Tamariki, ‘I need to know X, Y, Z’, depends what I’m asking for. Then it depends what they decide to share, the quality of what they share with me, so that’s another point where information can be either fall away or can enrich what we know about the situation. And then, depending on what is shared with us, what we then understand by that sharing, and then as a result what action that we take to follow up.

[Slide on screen: Quality of recording]

Often think that when we write case notes, that we think we’re writing them for ourselves as memories for us so that we can look back and see where our work was at. And I guess what I’ve come to understand more and more is that the notes are for the next person, not for me. It’s not an aid memoir for me, it’s about what I want the next person to know and to understand, which is so, so very important. So, when I’m writing case notes or thinking about a piece of work and how I’m going to represent it, I’m looking at it with the view of, how could this be read or interpreted?

[Slide on screen: Accurate language is a prerequisite for safety]

Okay, this is a little bit of thinking about language and the language that we use, and it’s from the work of Allan Wade and Cathy Richardson who worked towards something called Response Based Practice. They’re Canadian practitioners but I find their work really, really helpful when we’re thinking about language. And I’ll give you some examples, but I’ll just run through these points first, and they call it ‘old speak’ or the way that we don’t want to speak which is, sort of, inaccurate language. So, we want to be avoiding any language that conceals violence in the way we record things. So, we don’t want to be hiding any of the violence, we want the violence to be visible.

What we don’t want to do is blame victims of violence for the violence that they’re experience [sic] in the way that we write things, and I think there’s ways that we sometimes fall into those common errors of victim blaming. We don’t want to hide responsibility for who is doing what to whom, so we want to be really clear about the actual acts of violence and who is doing them. And we also need to be really careful about hiding people’s responses and resistance to the violence, and that’s based on the idea that whenever there is violence or oppression, that there is always resistance to that violence.

Sometimes it’s very hidden and secret because it’s not safe for it to be visible from under the lights. But we need to understand that it’s there, it will be there, and to understand what it looks like. And I think when we understand how people respond and resist violence, if I go to the other side, it honours victims’ responses and it makes it more clear that they weren’t passive recipients of violence. There’s a response there and it may not be obvious but it’s there.

In terms of if we want to go into more safely speaking about violence, we want to be very clear that our language exposes the violence and is very clear about who is doing what to whom, that it aligns with the people that are being hurt by the violence, so that’s the victims of that. And when I use that word, I’m including Tamariki and children in that word, people who are experiencing the violence. That might be the adult survivor, but I’m making sure that I’m very clear that that’s including children, and I’ll talk about that language in a minute as well.

And, thirdly, that in order to be thinking about, writing about, speaking about violence, we need to be clarifying who is responsible for the violence. So, violence is usually an act by one person towards another person, and so we’re just being clear about who is doing that.

[Slide on screen: Knowing what words mean]

I’ll give you some examples and this is really some examples from practice. I wish I had a dollar for every time I’ve seen this statement, ‘They have a history of family violence together,’ or ‘This is a violent relationship,’ is another form of that sort of language. And what that does, is it makes the violence mutual; it’s not being clear about who is doing what to whom. So, if we’re thinking about that, we want to be much clearer about that, so instead we might say, we might be describing a pattern of escalating violence and we’d be thinking about by whom to whom.

So, on the lefthand side the example is that a child witnesses abuse. And I guess what we’re thinking about more is children don’t witness abuse, they experience abuse, that violence between adults, even if the children are not in the home or don’t see it or hear it, it doesn’t mean that they don’t live with the impacts of that violence. So being very clear about that language. Thinking about separation, instead of thinking about it, I tend to find in family violence work that when couples separate there’s kind of a bit of a relief that the violence is going to end, instead of understanding it as a continued and actually heightened risk of violence, much more likely for lethal violence to be used post a separation.

Words like ‘perpetrator’, and ‘victim’ words. They tend to focus us on the incident at hand, and I’ve seen many cases where there’s been POL400s from police, where the primary victim has been identified as the perpetrator, and the predominant aggressor has been identified as the victim. And that’s because we’re using an incident-based approach. So, if we only look at what happened on one particular time, we can run the risk of misidentifying who, in fact, is the primary victim and who is the predominant aggressor, because that is about a pattern over time. For instance, when I go to some family safety meetings they might say, ‘Oh, there’s been 36 incidents between this couple,’ and that’s another way where we mutualise it, and we suggest that we’re not being very clear about who is doing what to whom. So, if you just hear that information, you might be lulled into thinking that there isn’t someone who is being victimised and someone who is using violence, you’ll be lulled into thinking that they’re doing it together. It leads us into the thinking around, they’re just as bad as each other, which is another common thing I often hear.

Lastly, thinking about safety plans and thinking more, what I would be encouraging people to think more about, is safety conversations.

[Text on screen: Julie Sach]

Where we’re talking with people who are subjected to violence about, not just what they can do, because I think that’s a problematic framing up but it’s about what we have to do as well, what are we doing as workers to contribute to the safety, what have they tried in the past, what have they done before, what’s worked, what hasn’t worked, why hasn’t it worked? So, we’re trying to think about exposing the tactics of the person who’s using the violence, because usually there are some pretty deliberate strategies that are designed to work with that particular person.

The other thing about safety plans and case notes is that we often used to see accounts saying a safety plan’s been written and then it’d be really difficult to see it, so what is the safety plan? Has that been communicated to other people that we’re working with? Is this a collaboration or is this going to sit on a case note somewhere so nobody else knows about what the plan is? And the other thing I’d say about safety plans is often they can be to-do lists for victims, and they’re generally fairly predictable and templated, the ones that I’ve seen in death reviews. Things may be changing, I’m just telling you my observations from that work. Is that often it was about what the victim should do, and I guess what we’re saying and thinking about is, how do we contribute to what we can do as well as workers in this space? How are we contributing to safety? Because if a person’s come to talk to us about family violence, they’re coming because they need our help, they need our support and where are we in that plan? Yeah, that’s just an observation.

[Slide on screen: Pitfalls and how to avoid them]

Thinking about some of the pitfalls and how to avoid them in our case noting processes. 

[Slide on screen: Misunderstanding/misconstruing the story) 

Ways that we can misunderstand or misconstrue the story is when we leave out some details, that’s pretty obvious. I’m thinking, there’s a very famous case in Britain of Victoria Climbié, who is a little girl who was murdered by her great-aunt and her partner. When they did the review of that, there were plenty of social workers and family workers and police who talked about their concerns, but they weren’t written down.

So, there was a lot of other material, which was the second point, too much miscellaneous detail is included with no analysis of what it means. A number of the workers, and this is true in other cases in New Zealand, that a number of workers say, ‘Yeah, I was really worried about that,’ but the worries and concerns weren’t documented. But instead, sometimes I’ve seen case notes written where there’s just, almost like, I call it a stream of consciousness case note, where you just write what’s in your head as if you were just describing everything without coming to any conclusion or thinking about what all this information means, because that’s the critical bit, is what’s the meaning that you make from what you’re seeing, observing, hearing, what conclusion do you as a worker come to.

And sometimes I’ve heard workers say that, ‘Well, that’s not fact,’ and that somehow there’s an idea that case notes have to be actually factual, and I’m going to come down to that in a minute where we talk about record writers sticking to the facts, and they’re leaving their practice wisdom or their intuition, because they’ve been taught somehow that that’s not appropriate; so I want to encourage you to think, ‘Well, actually…’ I try to reframe it as, it’s not just intuition, it’s professional judgement actually. You know, if you’re working a case and you’ve seen cases like that before and it gives you some concerns because of the study you’ve done, or the work that you’ve done, the experience you bring to the role, then that’s your professional judgement and that’s totally legitimate to commit that to paper and communicate that and talk to other people about it. It may not always be right but it’s your current thinking, and it’s okay because you can revise your current thinking, it doesn’t have to be, but you have to then record your revised current thinking.

Another problem in case notes is that sometimes they can be too focused on the current situation, so not having a longitudinal view of the situation, sort of like a pattern over time, what are the patterns of violence that we’re seeing. So, we’re looking for a chronological perspective. 

[Slide on Screen: Leading to terrible outcomes] 

And these misconceptions can lead to some pretty terrible outcomes, so this is trajectories in case files, filtering out information in the recording process, and child protection. So, this is, records didn’t provide an overview of a case because core information often drowned in miscellaneous details and narrative text and was spread over various documents. So, the importance of having a coherence to the story.

And I talked about Victoria Climbié before, but that was also disturbing observations and other relevant details totally absent from the records and, consequently, the seriousness of the issues was not conveyed to readers. 

So, we’re just looking at the kind of things that can go wrong.

[Slide on Screen: Record-keeping expectations] 

And this is one of the things we’ve found time and time again, that in order to have a coherent and comprehensive history of someone’s situation, our systems, our forms and our templates, now it’s really hard to read this but it says, ‘fragment the holistic information into pieces.’

So, you can see that as you have every slash it becomes harder and harder to read that. When that becomes how it is, then it’s really easy for workers to lose the narrative because it’s not… you know, there’s a bit of information on the intake form, then there’s a little bit more information in the case plan, there’s something in the safety plan, but they might be held in three separate parts, and where’s the coherence in bringing it together that we’re looking for to make it easy on ourselves to be able to retrieve that information or as we read it, for it to make sense to us.

[Slide on Screen: Filters]

I’m going to talk to about the filters that we bring to the work. These are kind of the big intersectionalities of racism, sexism, and ableism. And how they, when we talked about how workers filter through the work, these things can be at play in the way we do that as well, and I’m going to talk about one in particular.

[Slide on screen: Dominant gendered stereotypes]

I’m going to talk about sexism bias, and I’m talking about that in family violence because, predominantly, we’re talking about violence that happens male/female, although I recognise that’s very hetero-normative, but that’s how predominate cases that would come through.

I’m looking at the dominant gendered stereotypes, and so, sometimes in case notes we can see the way that workers are thinking about mothers, who are parents in the context of domestic violence, as failing to protect their children, you know, she’s staying even though there’s violence, so she is not protecting her children. That’s problematic because, actually, the person whose behaviour we need to be focusing on is the person who is being violent, and if we get diverted into trying to understand mum’s motives and why she’s staying and giving her labels that are quite pathologizing, words like, ‘she’s co-dependent.’ That’s one way I’ve heard it framed up of why women stay, but there’s a myriad of ways we do that. But what we need to understand is that doing that, is part of a dominant, gendered stereotype, where we’re often holding females accountable for the violence they’re experiencing.

The other way we can do it is the opposite, is making men who choose violence invisible by collecting limited evidence about their patterns of perpetration, and their fathering practices. I can give you some examples of reading case notes where the worker was recording all the things the father was doing around the house. So, ‘Oh, I called in today and dad was doing the dishes.’ ‘I called in today and dad was out hanging out the washing.’ And the implication is that he’s a really good dad because he was doing those things. He was actually highly abusive, and he was doing a whole lot of other things, but he’s very careful about what behaviours he got workers to see, and then they were collecting that as evidence of him being a really good dad; and in fact the opposite was true.

But that’s a gendered thing, and I think it’s so dominant that we don’t even sometimes see it. I was at the airport the other day and I saw a little child running up to dad and he picked her up and scooped her up, threw her in the air, and I thought, ‘Oh, my god, he’s such a good dad.’ Then I thought, ‘Well actually, that bar’s really low.’ We have quite a double standard around our expectations for mum and our expectations for dad. We usually need mum to know all the children’s routines, know if their medicines are up to date, understand where their schooling’s at, attend parent teacher interview.

You know, the list for what mums need to do is pretty long, and for dads, well, they need to show up. They probably need to not be using drugs and they need to earn a living. So, it’s quite a gendered way of thinking about mums and dads and who’s responsible for what. I’m just alerting you to that, as a potential that can happen even in the way we record things.

And the third one is really, how we can decontextualise the survivor’s mental distress or problematic substance abuse. So, we’ve got examples where women may be suffering from depression, PTSD, anxiety, things like that, and we don’t see that in the context of family violence, and we’re not joining up the dots and thinking about, was that present before the violence? How is his perpetration of violence impacting on her mental health? How is it contributing to it or exacerbating it, or making it worse? The other one is mum’s drinking a lot. That’s a very common thing that we find written in case notes, but the thinking behind that, about what’s driving this drinking behaviour, and often when you’re talking about family violence you’re talking about coercive control where partners insist people sit down and drink or drug with them.

And then, we’ve had situations where partners have done that, and then they call Child Protection Services to let social workers know that that’s happening, to cast her parenting in a bad light, because they’re also threatening. One of the controlling ways is, I’m going to get your children taken off you. That’s a perpetrator coercive control tactic, which it strikes fear in a lot of mums’ hearts.

[Slide on screen: More accurate accounts]

So, just some examples from Family Violence where what a less accurate account looks like and then how we’ve made it fuller. So, instead of ‘Mum’s returned to the family violence relationship.’ We can write a little bit more accurately, ‘My mother reports she’s left her partner six months ago. She says his continuing threats to take the children away have forced her to return to live with him.’ So that’s a much fuller account, and if we go through, it’s kind of, if we go back to the four things we’re trying to do with accurate language, it’s kind of aligning with her.

Because we’re understanding the pressures that she’s been put under to go back to live with him, so we’re not holding her accountable, as if she had that choice and made that freely and of her volition and she just said, ‘Yeah, I really want to go back to live with him.’ She’s actually doing it in the context of wanting to continue to have a relationship with her children, and his pattern of behaviour to interrupt that.

Comments like, ‘The father’s not included in the referral.’ Instead of saying that, being more accurate would be to say, ‘Made consistent attempts to engage the dad over 12 months. He wouldn’t answer worker phone calls although his partner reports he has a working phone.’ Instead of thinking about children witness domestic violence, ‘The children have been exposed to domestic violence perpetrated by their mother’s current partner over the past three years. Because of his violence, they have been homeless, had to change schools and been isolated from their peers.’

So, we’re linking the impacts on the children back to the perpetrator’s pattern of abuse, which is really important because otherwise we run the risk of slipping into victim blaming, because we might understand the family’s homelessness as caused by mum, whereas we’re linking it here very clearly to the violence.

And ‘Mum has a history of non-compliance with her medication.’ Instead of saying that, we’re saying the patient has disclosed ongoing DV perpetrated by her partner.’ So, we’re being clear about who was doing what to whom. ‘She reports he often steals and sells her prescribed meds, meaning she goes for days when she can’t access them, and she says her anxiety gets worse when she can’t access her meds’.

So we’re contextualising her mental health issues into the context of violence, and that’s really important that we do that, otherwise we’re taking a siloed approach and we’d just be suggesting that she needs to take her meds more regularly, which leaves the obligations and the responsibilities with her whereas, actually, what we want to do is for this behaviour to stop, the stealing and selling her meds is what we need the person who’s choosing violence to stop doing because that’s part of a pattern of coercive control.

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