Lessons from serious case reviews: Disguised compliance

Disguised compliance involves parents giving the appearance of co-operating with child welfare agencies to avoid raising suspicions and allay concerns (for a more detailed description see NSPCC factsheet below).

Published case reviews highlight that professionals sometimes delay or avoid interventions due to parental disguised compliance.

The learning from these reviews highlights that professionals need to establish the facts and gather evidence about what is actually happening, rather than accepting parents' presenting behaviour and assertions.

By focusing on outcomes rather than processes, professionals can keep the focus of their work on the child.

Reasons case reviews were commissioned

This briefing is based on case reviews published between 2011 and March 2014, where disguised compliance is a key factor. It pulls together and highlights the learning contained in the published reports.

In these case reviews, children died, or were seriously injured in a number of different ways:

• Physical abuse, including head injuries and shaking
• Neglect, including dehydration and malnutrition
• Co-sleeping with parents who had consumed alcohol and drugs
• The ingestion of drugs.

Babies and very young children are at particular risk from a lack of timely intervention due to disguised compliance.

Risk factors for disguised compliance in case reviews

Missing opportunities to make interventions
A reduction or downgrading in concern on the part of professionals can allow cases to drift, so losing the opportunity to make timely interventions.

Removes focus from children
Disguised compliance can lead to a focus on adults and their engagement with services rather than on achieving safer outcomes for children.

Over-optimism about progress
Professionals can become over-optimistic about progress being achieved, again delaying timely interventions.

Recognising disguised compliance

Parents deflecting attention
Parents focus on engaging well with one set of professionals, for example in education, to deflect attention from their lack of engagement with other services.

Criticising professionals
Parents criticise other professionals to divert attention away from their own behaviour.

Pre-arranged home visits
Pre-arranged home visits present the home as clean and tidy with no evidence of any other adults living there.

Failure to engage with services
Parents promise to take up services offered but then fail to attend.

Avoiding contact with professionals
Parents promise to change their behaviour and then avoid contact with professionals.

Learning for improved practice

Establish facts and gather evidence
Don't accept presenting behaviour, excuses or parental assertions and reassurances that they have changed or will change their behaviour. Establish the facts and gather evidence about what is actually occurring or has been achieved, in order to not lose objective sight of what is happening.

Build chronologies
Chronologies can be used to provide evidence of past parenting experience, including possible former instances of disguised compliance, and to analyse parenting history. The information can then be considered in relation to current parenting capacity and to gain a fully documented picture of the family environment. This can help in recognising and understanding further incidences of disguised compliance.

Record the children's perspective and situation
Recording can become focused on the adult's participation and parenting capacity. Instead, the focus should be on recording the children's perspective and situation.

This will help to retain the focus on the child and can also help to ensure that important information does not become lost when shared between multiple agencies.

Identify outcomes
Focus on outcomes rather than process, so that attention cannot be deflected by good intent or an appearance of participation. Identify and establish clear, understandable and measurable outcomes and take action when outcomes are not achieved within agreed timescales.

Use of staff supervision to challenge beliefs
Professionals can become overly optimistic about change that has occurred.

This can involve rationalising parents' behaviour to their own viewpoint, for example seeing a failure to engage with services as a matter of "parental choice" rather than non-compliance, or an over-optimistic desire to believe change has occurred.

Supervision needs to challenge professionals' beliefs about apparent changes and to seek evidence of actual progress.

GUIDE TO DISGUISED COMPLIANCE

What is disguised compliance?
The term describes a parent or carer giving the appearance of co-operating with child welfare agencies to avoid raising suspicions, to allay professional concerns and ultimately to defuse professional intervention.

It is attributed to Peter Reder, Sylvia Duncan and Moira Gray who outlined this type of behaviour in their book Beyond Blame: Child Abuse Tragedies Revisited (Routledge, 1993).

It describes the circumstances when this occurred: "Sometimes, during cycles of intermittent closure, a professional worker would decide to adopt a more controlling stance. However, this was defused by apparent co-operation from the family. We have called this disguised compliance because its effect was to neutralise the professional's authority and return the relationship to closure and the previous status quo."

Examples of disguised compliance would be a sudden increase in school attendance, attending a run of appointments, engaging with professionals such as health workers for a limited period of time, or cleaning the house before a visit from a professional.

When does disguised compliance occur?
Disguised compliance occurs when parents want to draw the professional's attention away from allegations of harm. It is often highlighted as a theme in serious case reviews. A biennial analysis of serious case reviews 2003-05 identifies disguised compliance as a theme (Brandon et al, 2008): "Apparent or disguised co-operation from parents often prevented or delayed understanding of the severity of harm to the child and cases drifted. Where parents… engineered the focus away from allegations of harm, children went unseen and unheard."

Apparent compliance can affect the professional's engagement with families and children.

Brandon et al's analysis talks about patterns of co-operation and the effect disguised compliance has on child protection workers: "Disguised or partial parental compliance also wrong-footed professionals. Apparent parental co-operation often prevented or delayed understanding of the severity of harm to the child."

How can professionals identify and counteract disguised compliance?
Disguised compliance can make it very difficult for social workers who are involved with a family to maintain an objective view of progress in safeguarding the welfare of a child.

Local safeguarding children boards (LSCBs) or regional child protection committees may produce guidance for social workers to ensure professionals are aware of the practice of disguised compliance and to alert them to the signs. For instance, there may be no significant change at reviews despite significant input from professionals, the child's account may differ from that of parents/carers, or parents/carers may put little effort into making agreed changes work (Peterborough Safeguarding Children Board, 2008).

In the Victoria Climbié inquiry, Lord Laming suggested social workers needed to practice "respectful uncertainty", applying critical evaluation to any information they receive and maintaining an open mind (2003).

Guidance from the Centre for Excellence and Outcomes in Children and Young People's Services (C4EO) emphasises the need for professionals to constantly question all assumptions by playing the devil's advocate or bringing in a fresh pair of eyes.

This can be supported through the provision of high-quality supervision, concluded C4EO in 2009: "Most commentators observe that the quality of supervision available is one of the most direct and significant determinants of practitioners' ability to develop and maintain critical mindsets and work in a reflective way."

A knowledge review conducted in 2010 for C4EO focuses on working with vulnerable children in families that are "resistant to change". The review analyses this complex description, but the fundamental concern is how child protection services can better intervene with families that cannot or will not engage.

Articles by Easton (2009) and McNabb (2009) provide a discussion on the theories and practices used by social workers when confronted with disguised compliance and the circumstances in which they need to put these theories into practice.

Source: NSPCC disguised compliance fact sheet