By Richard Devine, Consultant Social Worker | Visiting Researcher at Cambridge University | Trainer, Speaker, and Author of Messy Social Work
Introduction
Key Components of Assessing Capacity to Change
Best Practices
Conclusion and Summary
Guiding questions
Check out our podcast episode on how to assess capacity to change, including the bonus of hearing from Lee, a father with lived experience: click here
Introduction
Assessing the capacity to change is especially hard in child protection.
Here are five ways a parent might respond when asked to address their alcohol use:
- Parent A: “I’ve made no change. I’m too scared to live without alcohol—it’s the only thing keeping me going. Even if I wanted to stop, I couldn’t. Anyway, why should I?”
- Parent B: “I really want to change. I can see how alcohol is ruining my life and damaging my children, but I just can’t seem to stop. If I tell the social though, they will take my kids away from me”
- Parent C: “I’ve reduced my drinking, partly because I didn’t like how much I was drinking and partly because social services keep bringing it up. I’ll tell them I’m only drinking once a week now instead of seven times, even though it’s probably more like three or four. Still, that’s more than half. I think this whole thing is being blown way out of proportion
- Parent D: “I’m attending every support service. I’m so keen to show I’m willing to change, and attending all my appointments is important, definitely makes the social happy. I just haven’t managed to reduce my drinking yet.”
- Parent E: “I’m not going to any of those crappy courses—they’re full of junkies, and I’m not one of them. I’ll prove to myself and everyone else by cutting alcohol out of my life forever.”
Our job would be far more straightforward if we had access to all this information upfront.
But now imagine each of these parents told us only this:
‘I have changed and massively reduced my drinking’
This highlights the fundamental challenge of assessing capacity to change.
Each parent’s readiness and ability to change is vastly different, yet their words might sound almost identical.
Key Components of Capacity to Change Assessments
Assessing capacity to change should involve five elements:
- Identify key issues and assess behaviour patterns: Consider the duration, severity and frequency of concerning behaviours to evaluate the potential for change.
- Identify what support has already been provided: Document previous support and interventions, understanding what has been tried before to avoid redundancy.
- Evaluate the effect of support: Examine the results of past support, including engagement levels and whether the support effectively addresses the issues.
- Consider what support could be provided: Identify additional support that could enhance protective factors or address risks.
- Provide an analysis of support: Assess the parent’s probability of engaging with services, potential effectiveness, time needed for change, and impact on the child.
Best Practices for Each Component
1. Identify Key Issues, Evaluate Patterns and Underlying Factors:
Using past behaviour to predict future behaviour is critical when evaluating behaviour patterns.
As Munro states, ‘the best predictor of future behaviour is past behaviour’.
When I started, I felt uneasy about using past behaviour to judge future behaviour because it seemed unethical.
And I wanted to hold on to the belief that people can change.
Indeed, I felt that much of the good fortune I have experienced is because I was given a chance and not unduly judged by my past.[1]
This optimism for parents’ capacity to change could be considered a bias, what I call a ‘positive outlook on change bias’ (not as catchy as the scientifically validated biases).
I think the ‘positive outlook on change bias’ is a useful interpersonal tool because I believe it is essential, if not morally necessary, that we convey to parents that we think they can change, even when the odds are stacked against them.
But in terms of assessing risk of harm, it is perhaps less helpful.
Another difficulty I encountered was that parents would often convincingly describe how their situation was different and how they had changed, but their reasons for this may vary.
Therefore, evaluating the probability of harm requires exploring factors other than the quality of our relationship with a parent and their expressed commitment towards change, which returns us to Munro’s argument.
In reviewing past behaviour, I think there are three key variables to consider, most of which can be drawn out from the chronology (which is the most important tool available to social workers, imo):
- Duration. This provides information on how long the pattern of behaviour has been in place (the longer the pattern has been in place, the less likelihood of spontaneous change).
- Severity of the pattern. This provides information on how entrenched and problematic the behaviour is and the support that will be required. To give an example, two parents could suffer from depression, and one of them feels low and unmotivated one or two days a week. In contrast, another parent could be debilitated, unable to get out of bed and leave the home.
- Frequency. This provides information on the severity of the problem, the impact on functioning and whether an issue is improving or deteriorating.
Of course, the caveat to using the past to judge future behaviour is that people can change at any time.
A parent who has misused heroin for 20 years can decide to end that addiction in an instant. Unlikely, admittedly. But it’s not infeasible.
Reviewing and analysing a parent’s history doesn’t preclude the possibility of change, but it does provide important clues, probably the most valuable clues we have, about whether change is likely or not.
Patterns of behaviour that manifest in different contexts or across time are predicted to be more resistant to change.
Conversely, patterns that are context-specific are more likely to change, especially if the context that facilitated the pattern changes.
When thinking about change, the stronger the evidence that the behaviour is chronic, entrenched, and frequently interfering with their parenting, the more substantial the evidence we need to see that change has occurred.
For example, a father I worked with had managed his emotions and relationship with aggression and violence for two decades in multiple contexts (family relationships, work, neighbours).
His behaviour remained unchanged as he matured, showing resistance to both personal reflection and legal consequences.
Despite his persuasive and emotional pleas during my visit, the likelihood of meaningful change appeared very low.
To be convinced otherwise would require a significant period of time where concern for his violent tendencies wasn’t an issue and, ideally (although not always necessary) evidence that he had engaged in the appropriate support that would bring about change.
Analysing Underlying Issues. I believe most people want to live healthy, happy lives. When parents exhibit harmful behaviours, I assume something has derailed them.
Understanding the underlying factors behind their struggles can aid compassion and provide insights into what support may actually help.
Childhood trauma, for example, often plays a significant role in shaping harmful behaviours.
Examining a parent’s upbringing and history may clarify the reasons behind their actions, offering clues about the types of support needed to bring about real change.
[1] In the third edition of Effective Child Protection, Munro added to this quote and the newer, fully extended version is, ‘the best predictor of future behaviour is past behaviour (though people can and do also change)’, to prevent it being used as an absolute rule (2019, p.147).
2. Consider what support has already been provided
Reviewing past support provided is essential to understand what’s already been attempted.
For example, I once worked with a mother, Jackie, who had attended three parenting courses, each referred by successive social workers. I, too, referred her for another course without realising this.
Each referral led to mild improvements, but the same concerns continued to arise.
Reviewing the support allowed me to avoid doing the same thing over and over.
If support didn’t work the first three times, it’s unlikely a fourth would make a difference.
Analysing past support outcomes can highlight patterns.
If a parent repeatedly fails to engage, this might indicate a lack of readiness or suitability of support offered.
Alternatively, if engagement was present but outcomes didn’t materialise, the support might have been inappropriate for the family’s specific needs.
3. Consider the effect of support
Engagement with support services isn’t evidence of change.
A parent might attend every course offered yet not make the necessary changes.
Actual evidence of capacity to change is found in the child’s lived experience: has the child’s environment become safer, more stable, and supportive?
This might be an outcome of service engagement, but not necessarily.
Equally, a parent could avoid support services but still make positive, independent changes.
4. Consider what support could be provided
The case law that underscores the importance of considering what support could be provided when assessing a parent’s capacity to change includes Re B (A Child) [2013] UKSC 33 and Re B-S (Children) [2013] EWCA Civ 1146.
- Re B (A Child) [2013] UKSC 33
- This case highlighted the necessity of thoroughly exploring and exhausting all support options before considering the removal of a child from their family. It reinforces that assessments should consider the parent’s current capacity and whether appropriate support could enhance their capacity to provide safe, stable care. The judgment emphasises that, whenever possible, less interventionist approaches should be preferred to allow parents the opportunity to make necessary changes with support.
- Re B-S (Children) [2013] EWCA Civ 1146
- Re B-S further developed these principles by stressing the importance of clear, evidence-based decision-making in cases of potential removal. The court emphasised that assessments must evaluate all feasible support services and interventions that could enable parents to care for their children. This includes assessing the likelihood of engagement with support services and whether such support could realistically address the concerns within the child’s timescale. Re B-S set a high standard for the clarity and thoroughness required in evidence supporting care orders, pushing for a detailed exploration of support options and realistic evaluations of potential changes.
Additional Case Considerations:
- Re C (A Child) [2013] EWCA Civ 1257
- This case reaffirmed that support should be considered as part of a “holistic assessment” of the parent’s capacity to change. The ruling emphasised that practitioners should evaluate the parent’s current circumstances and consider any support that could potentially mitigate risks or improve their parenting capacity.
Here are 3 key ideas that help me think about the support that could be provided:
Fix the person or change the system There are two ways I can help a parent and increase safety for a child.
Ref: Working with Denied Child Abuse by Andrew Turnell and Susie Essex
Firstly, we can support the individual (i.e., the faulty bulb), for example, by encouraging a parent addicted to drugs to access treatment for their addiction.
Secondly, we can create safety that lessens the risks derived from a parent’s behaviour.
For example, for a substance-using parent, we could look at support via a Family Group Conference, consider the child accessing extra-curricular activities, and Safety Planning.
Our goal in child protection is two-fold: to reduce risk and increase safety.
We can’t eradicate risk, so our purpose is to reduce it enough to protect the child from undue harm.
Sometimes, we can achieve this by fixing the lightbulb; sometimes by improving safety (and not changing the risk); and sometimes, a combination of both.
We can quickly get stuck if we just focus on fixing the person.
Critical Cause of Danger and Critical Cause of change
We often tangle ourselves up with multiple difficulties experienced by a family and expect them to change too many issues at once.
Critical cause of danger = a key area of concerns and the underlying factors contributing to it
Critical cause of change = that, which, if changed, would instigate a cascade of changes that would ultimately resolve other concerning aspects of the family’s functioning
For example, the use of drugs and/or alcohol by parents can often lead to:
- chaotic home routines
- inconsistent parenting
- financial problems, including debt
- poor mental health
- parental conflict.
If we ask a parent to address their drug and alcohol use, there are a few ways in which to do this: 1:1 and group work through community drug and alcohol services, Alcoholics Anonymous or Rehabilitation Centres.
This should be our primary focus.
Yet, often, we ask parents to engage in support to address their substance misuse AND
- engage in 1:1 family support to improve routines
- attend a parenting course for inconsistent parenting
- attend an appointment with Citizens Advice Bureau for help with budgeting
- attend the GP and access mental health support
- engage in domestic abuse services.
As pointed out by Crittenden (2016: 285), ‘too many goals and too many professionals working toward the goals are likely to distract attention, generate anxiety about performance and change and obscure the critical aspects of the treatment’.
In assessing capacity to change, is there one key issue that we can focus on?
Matching the intensity of support with intensity of need
In Raising Parents (2016), Crittenden outlines a framework called ‘The Gradient of Interventions’ that changed my thinking on support for parents.
The basic principle underpinning this is that the greater the parent’s reflective capacity, the less intense the resource will need to be to help.
Conversely, parents with limited reflective capacity require more intense and significant support.
For example, parenting programmes work best for parents with high levels of reflective capacity and need new techniques and ideas that they can apply in what is otherwise a relatively well-functioning household.
This is a low-resource support service.
Short-term counselling is another low-resource support service, and in my experience, it is suited to parents with a single-issue adverse life event or for someone who understands their problems but needs another perspective to help them.
I did not find this suited a parent who had severe or enduring psychological and relational difficulties, which accounted for most of the parents I worked with.
Somewhere in the middle is parent–child intervention, for parents who recognise that they have difficulty in their relationship with their child and need help accurately perceiving their child’s needs.
In other words, they have some reflective capacity but require a relatively intense support service to help them improve their relationship with their child.
A parent with significant psychological or relational issues and low reflective functioning requires a resource-intense service such as adult psychotherapy.
For a parent with an addiction, they will need support with that beforehand, and generally, the more severe the addiction, the more intense the treatment will need to be.
The most resource-intensive service is adult life assistance.
There are some families where the level of need, psychologically and practically, is so great that they require ongoing services that help the family meet their children’s needs.
It might be that there isn’t any intervention that will ‘fix’ the issues within the family, but with ongoing care and support, the children can remain safely in their parents’ care (see Fostering Families)
A key argument made by Crittenden is that it is common to hold parents’ responsible for accepting and benefitting from the services offered. When they don’t, the parents are often considered ‘resistant’.
Crittenden says, ‘I am confident that almost all parents, want the best for their children, I try to compare parents’ readiness for particular services with the services they were offered’ (Personal communication, 2020).
5. Analysis of Likelihood of Engagement and Success
Assess the likelihood of the individual’s engagement and the potential for positive outcomes.
This analysis asks you to evaluate several key factors:
- Willingness to Engage: Assess if the person will likely participate in the process or intervention.
- Effectiveness of Approach: Evaluate if this intervention or action plan is likely to produce the desired outcomes. Will it genuinely address the issues at hand?
- Timeline for Results: Estimate how long it may take to see any positive changes or outcomes.
- Impact on the Child: Consider what these changes will mean for the child. Will the outcomes improve their situation and well-being in meaningful ways?
Each of these aspects is critical in predicting the success of the intervention and understanding its potential impact on the child.
Conclusion
When evaluating support for a parent in child protection, outcomes often fall along a spectrum shaped by the parent’s progress, the effectiveness of the support provided, and the resulting impact on the child.
Positive change is the ultimate goal, and while engagement with services often drives improvement, it is crucial to recognise that some parents make significant changes independently or through informal support networks.
- Positive change: The parent demonstrates substantial progress by fully engaging with support services or making changes independently. This results in improved parenting capacity, stability, and reduced risks, allowing the child to remain safely at home.
- Some positive change: The parent makes some improvements but continues to face challenges. This scenario typically requires ongoing support.
- Limited change: The parent shows limited progress because they engage inconsistently or face significant barriers to change. In such cases, temporary care arrangements, such as placement with extended family, may be needed to ensure the child’s safety while continuing to work with the parent.
- No change, with evidence of deterioration: If the parent’s situation deteriorates or fails to engage meaningfully, the risks to the child may increase. Currently, there are no support services that would mitigate the risk.
See below for questions to use to aid thinking.
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- Identify key issues and assess behaviour patterns.
What are the specific behaviours of concern (e.g., substance misuse, domestic abuse, neglect, etc)
How long have they been occurring?
How often do these behaviours happen, and how severe are they?
Are there any patterns or triggers for these behaviours?
What are the underlying causes to these behaviours?
When have there been exceptions to the problems? What was happening at the time? Was the problem less severe or didn’t exist?
- Consider what support has already been provided.
What interventions or support services have been provided to this parent in the past?
- Consider the effect of support.
Were these services delivered consistently and in a timely manner?
How did the parent receive the support? Did they actively engage with it?
What lessons can be drawn from the success or challenges of previous support?
What outcomes can be linked to the support that was provided?
Did the support result in measurable changes in behaviour or circumstances?
How did the parent engage with the support—actively, sporadically, or not at all?
Did the support address the underlying issues, or were only surface-level changes observed?
- Consider what support could be provided.
Are there gaps in the current support system for this family?
What additional services or interventions could directly address the identified risks or strengthen protective factors?
- Provide an analysis of support.
What is the likelihood of the parent engaging with future support based on past behaviour?
How effective do you anticipate the new support would be in addressing the concerns?
How much time would it take for meaningful change to occur, and is this time frame feasible given the child’s needs?
How would continuing or discontinuing support impact the child’s safety, wellbeing, and long-term outcomes?
By Richard Devine (06.12.24)