The Obesity Dilemma
SESSION OUTLINE
1
Child Protection Case Conferences
2
Signs of Safety (SOS)
3
Case Example
The Obesity Dilemma
PROBLEMS
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Families (and professionals) are intimidated
Their ability to engage is hampered
Research indicates that CPCs spend too long sharing
information at the expense of time spent on planning.
The Obesity Dilemma
RESEARCH SUGGESTS CONFERENCES
SHOULD:
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Have a greater focus on planning
Enable families to present their views
Ensure all views are grounded in evidence
Place a strong emphasis on relationships
Reduce power inequalities
Build on strengths
The Obesity Dilemma
Sir Harry Burns - The dangerousness of
hopelessness
“We need to be aware of the danger of making people passive
recipients of services rather than being actively engaged. This
increases their sense of hopelessness and being out of control”
The Obesity Dilemma
Signs of Safety
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Developed in Australia - Turnell and Edwards
Solution focussed - strengths based
Safety plan - safety at the heart.
The Obesity Dilemma
Practice Principles
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Respect service users as people worth doing business with
Cooperate with the person, not the abuse
Recognise that cooperation is possible even when use of authority
is required
Recognise that all families have signs of safety
Listen to what the family want
The Obesity Dilemma
SOS: Assessment and Planning Form
What are we worried about?
What’s going well?
What needs to happen?
The Obesity Dilemma
Three Houses
Worries
Good
Things
Dreams
The Obesity Dilemma
3 “P”s
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Preparation
Participation
Plan
The Obesity Dilemma
Danger Statements
If things carry on as they are, then:
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Michael's weight will continue to rise and this may mean a total loss of mobility for
him, leading not only to other urgent health problems but also complicating school
attendance and socialising.
Michael's health will get worse as more and more important medical appointments
are missed.
Michael will not go to school on a regular basis, making it harder to get good
results, meaning even less time with his friends and peers and not getting to the
activities he enjoys or taking part in after-school clubs.
Michael's sense of self will be badly affected by his poor housing; not being able to
get to the bathroom impacts on all aspects of his life.
The Obesity Dilemma
Worries
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Wheelchair basketball
bathroom at home
ankle
wheelchair
not being able to take part
missing appointments
missing school
The Obesity Dilemma
Good Things
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coming to school (best
thing)
being able to speak to his
Guidance teacher
enjoying playing the guitar
sport (watching and
wanting to play when ankle
allows)
bedroom at home
getting on well with his
brothers
taking part in activities at
school
The Obesity Dilemma
Dreams
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having a moonboot
not having to use a wheelchair
radio broadcasting next term
being a DJ in the future
house in Scotland with a bathroom
staying at school
going to university
making up songs
help for Mum
bedroom at home
getting on well with his brothers
taking part in activities at school
The Obesity Dilemma
SOS: Assessment and Planning Form
What are we worried about?
Michael:
• being in a wheelchair
Mum:
• medical staff have not done full
investigations and there are still lots of
'unknowns' about his health.
• his weight and that he can’t use the
bathroom
Professionals :
• M has gained 4 stone in past year ankle
problem deteriorating
• numerous health appointments not kept
even when M reminds Mum of their
importance
• hydrocortisone medication not given which
could be life-threatening
• diet advice not followed and mobility (use of
walking frame) not encouraged; being in a
wheelchair becomes vicious cycle for M
• M’s school attendance, he cannot make
use of school, community and out of school
activities
• housing access a bathroom and toilet
What’s going well?
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Michael likes school, is an excellent
reader and enjoys a range of activities
Michael has recently had a 'moonboot'
fitted which he hopes will help him be
more able to use his walking frame
Mum has found the move to Scotland a
positive one and has set up her own
business
Mum is working with supports to address
the family's housing difficulties and has
an appointment soon to look at options
for rehousing
What needs to happen?
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Michael to have his medical needs
reviewed through a 2 week hospital
admission planned immediately (during
school holidays) for variety of co-ordinated
tests, ensure medication given and
implement very-low calorie diet
Michael and his mum to know what they
must continue with, by use of full discharge
plan including diet and clear medical
programme of essential medications and
appointments that must be adhered to
Michael to be supported to attend disabled
swimming club
a house move with Michael having suitable
bathroom and toilet he can use
The Obesity Dilemma
Safety Goals
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Mum will work with Michael to make certain that he gets to all his medical
appointments so that all his health needs are properly taken care of.
Michael knows he has to lose weight. Michael wants this to happen so his mobility
will improve and he can aim for walking without his wheelchair. Because when that
happens, getting to school every day and doing normal activities will be easier for
him.
Michael will then feel better about himself as he can start working towards his goal
of staying on at school and applying to university. He can also regularly get to his
out-of-school activities like the radio broadcasting.
Moving house to one that has a shower & toilet that he can use, will mean he can
stop being embarrassed by not being able to wash properly, and be more
independent like his friends.