Care Order granted for anxious and fearful child– 2015vol2#16

A mother consented to a Care Order being made in respect of her child until he is 18 years old on condition that a review take place within two years and a review of access take place within six months. Despite the consent a lengthy hearing of the evidence took place.

The matter had been before the court in a provincial city in respect of Interim Care Order applications a number of years previously and the judge had directed that psychiatric reports be carried out. The judge had also asked that a psychosexual assessment of the child take place but the solicitor for the CFA told the court that a psychiatrist had advised the CFA that such an assessment should not take place until the child is older.

A psychologist gave evidence that the child had been referred to her for assessment and that she had carried out an attachment assessment of the mother and the child. In relation to the mother’s attachment style, the psychologist said that the mother had not had a background where her care-givers had given her what she needed and that this pattern had continued when the mother was taken into care. She said that the mother had experienced sexual, physical and emotional abuse throughout her developmental period.

The psychologist said that the mother had a “disorganised attachment style” which meant that she could be avoidant and suppresses her feelings through substance abuse, suicidal intent and self-harm which she used to escape her feelings. She said that she thought that the mother found it hard to regulate the child’s behaviour and that the child seemed not to go to the mother as a source of comfort. She also said that the mother found it difficult to interpret and respond to the child’s behaviour and that this affected the boy in “every way in terms of risk”.

The psychologist said that the mother seemed to experience “emotional dis-regulation” and when the child demanded something this acted as a trigger for her own emotions. The mother had been locked in a room as a child and had been a fearful child who had been told that she had been responsible for her own mother’s death. Because the mother’s needs are so significant she has great difficulty in terms of being available for her own child, the psychologist said. She had not had a positive experience of being parented and did not have much support in parenting. The psychologist thought that the mother would find it very difficult to meet the child’s needs and to detect and regulate his distress. She observed that the child seemed to have quite a controlling style in interactions with his mother but that he also seemed to find her frightening as he appeared anxious and fearful.

The court was told that the child became very “dis-regulated” after access visits with his mother and it appeared that access visits were causing him to re-experience trauma and anxiety. The CFA solicitor pointed out that as a result of this behaviour access with the mother had been suspended.

The psychologist said that the boy was showing an interest in sex and gender but that she did not believe that a psychosexual assessment should take place immediately. She thought that he should go on “his own journey” and that she did not think any assessment would be conclusive at this stage. She said that she had diagnosed the boy with “disinhibited social attachment disorder” as he was very socially disinhibited. She thought that it would be good for the boy to hear the result of the court application so that he would know where he would be living as he needed a stable relationship with his primary care-givers. She also said that the boy needed further attachment therapy and occupational therapy.

In relation to access with the mother, the psychologist said that before access can go forward the reason for the child appearing anxious and frightened after access needed to be examined and that any access should be supervised by someone with an awareness of attachment issues.

The same witness said that the child had been behaving very erratically at school and the teachers described him as “extremely challenging” due to his unexpected outbursts. She said that the boy had a need to feel and touch people and that this could be a manifestation of his attachment disorder but would need further exploration. The psychologist had spoken to the school about ways to manage the boy’s behaviour. She complemented the teachers at the school saying they were very motivated to learn how to help the boy. She also commented that one teacher had said that she had “never seen anything like this boy”.

In cross-examination by the mother’s barrister on the issue of access, the psychologist said that she saw the boy’s engagement with the mother and saw how he was upset and frightened. She also said that she appreciated how difficult it is for the mother (not to have access with her child) but that the boy’s needs had to be considered first. She said that the child was becoming very dis-regulated when he saw his mother.

When asked by the GAL what the implications would be for the boy if access were to recommence, the psychologist replied that she thought that if a Care Order was granted and access recommenced her fear would be that it would be “giving the wrong message” to the boy.

The judge asked the psychologist about a report identifying foetal alcohol syndrome in respect of the boy. She replied that she thought it was very important and that physical assessments in respect of that report should take place. The psychologist also said, in relation to supports the boy was receiving, that she felt that the current attachment therapy was sufficient.

In relation to access, the psychologist said that she thought it was an enormous dilemma in that a sense of family is very important but the evidence shows that access is very difficult for the boy so it would have to be called into question if it is very distressing for him. She thought the boy’s response to access was so negative that this outweighed any foreseeable benefits of access at the moment.

An art therapist gave evidence that her first observation of the child was his challenging behaviour and the fact that he was very angry. She said that when she started working with him he was “very hyperactive and challenging”. After the child had made a disclosure of sexual abuse she began to focus more on his emotional needs. When the CFA solicitor asked about the disclosure, the art therapist said that the child had told her that he and his mother had a lot of secrets and that he had been sexually abused by a neighbour and he asked that she would not tell his mother what he had said. She also said that the boy had been displaying sexualised behaviour. He had said that he was afraid of his mother and that she beat him with a wooden spoon and kept him in the closet when he was bold. The art therapist said that her work focussed on boundaries, nourishment and responding to needs.

The court heard that the attachment work with the boy had been interrupted because of a further disclosure had been made that the boy had been abused and that he had seen his mother taking drugs.

The art therapist said that she thought the boy did not feel safe and he lacked stability and that this was what was impacting on his confusion about identity
and lack of belonging and she thought this was reflected in his emotional and behavioural difficulties. She thought the fact that he believed he might be going back to live with his mum prompted the child to make the disclosure.

The art therapist said that she often saw the child after access with his mum and that he was very anxious and was using the toilet very often. She said she asked about the toilet breaks and it was clear that they were a kind of emotional regulation, “he was more relaxed, regulated after toilet breaks”. The boy had said that he had nightmares and that he wet and soiled himself and that she thought this was because of anxiety. She said she had seen the boy 71 times and during that time she could see progress. “When he came to me first, he was like a wild animal but he his doing better at school now.”

She also said that, with boundaries, the sessions are more structured and that he can follow the instructions and although he still had difficulties he is gradually progressing and his behaviour is settling down. When asked by the CFA solicitor whether the art therapist thought the decision today would have a positive effect on the boy she replied that she thought it would.

In cross-examination, the barrister for the mother asked the art therapist whether she thought that the excitement he demonstrated around access visits was positive. The therapist replied that she did not think the behaviour was positive as the child was singing very loud and was biting himself and picking at his hands. The therapist said that she had worries about re-traumatising the child if access were to start again.

The art therapist noted that the disclosure about the mother’s drug taking arose after a school trip to a Garda station where the children were shown drug paraphernalia.

The judge asked the art therapist about her description of the boy demonstrating gender confusion and emotional and behavioural difficulties. He asked specifically whether she thought these were a consequence of attachment difficulties or emotional or physical abuse or both or whether gender confusion might be due to a more fundamental reason? The therapist said that she thought that the gender identity issues were creating a lot of social difficulties but attachment difficulties created social problems too.

She said that the boy liked to dress in girls’ clothes and “play in a girly way”. She said that if he can play and be himself she thought he could get strength at school to be himself and will learn how to regulate social relationships. She thought that when the attachment work was completed it would help the boy at school. She recommended that the boy be looked at by a psychiatrist in relation to his behaviour, specifically his lack of empathy or remorse as well as his sexualised behaviour.

A social worker gave evidence of his interaction to date with the boy and said that initially he was not overly comfortable talking about himself. He told the court that after meeting the boy, the foster parents had reported that the boy had expressed a fear that the social worker would return him to his mother. The boy told the social worker that he wanted to be adopted by his foster carers and asked what would be happening to him. He had also said he wished to see his mother at his birthday and Christmas. The social worker said that when the boy mentioned his mother he would dig his pen very hard into the page he was drawing on and would almost become angry.

When asked how the social worker felt a decision on the Care Order application would impact on the boy, he replied that he thought it would be beneficial as the boy had been asking about the court proceedings. He said that when the boy asked him what was happening to him, the social worker had explained that the judge would make the decision about whether he would stay with the foster family. On hearing this, the boy “looked like he won the Lotto” and wanted to telephone his foster parents to tell them he would be staying with them.

The court was told that the boy was getting the full amount of resource hours at school and was getting a special needs assistant (SNA). The resource teacher was very positive about the boy and said that he was doing well. The social worker said that the boy was very interested in drama and was performing in a school play and going on a trip with the school to the West End.

In relation to access, the social worker said that the boy had said he is not ready to see his mother and his view was that access should take place at the boy’s pace. He said that any time he suggests that the boy write a letter to his mother he shuts down.

The judge pointed out that he thought the boy needed a comprehensive psychiatric assessment and asked that such an assessment be organised.

The GAL gave evidence that the boy told her about how he liked to play with dolls but that he was embarrassed that other children would laugh at him. He said that the other children at school gave him a hard time because he was no good at football. He also said that he liked to dress up and that he used to do that with his mum and that he wanted to be a girl. The GAL questioned whether his behaviour was indicative of a gender identity problem or whether the sexualised behaviour was indicative of a traumatic experience.

In relation to the gender issue, the GAL noted that the boy is coming towards puberty and that it would be important that advice be gathered about what steps to take. In relation to access she said that although it is important, it had to be recognised that the boy becomes dis-regulated after access but that she hoped that over time access could be re-established. She said that certain work that the mother would have to undertake was an important part of reinstating access and that in this regard the mother had attended a psychologist. She praised the foster carers saying that they had shown huge commitment.

The GAL also suggested that further sensory work should be undertaken but that she was satisfied that the appropriate supports were in place in school. The GAL supported the application for a Care Order until 18 for the boy and said that she hoped that the boy’s mother would continue to co-operate with the social work department.

The mother of the boy told the court that she had not seen her son for over a year and that she had brought birthday and Christmas presents to the social work department to give to him. She also said that she had written him a letter but had not received a response. She said that she would have no problem engaging in therapy. When asked by her own barrister whether she had been told of anything that she could do that might improve her chance of getting access to her son, she replied that she had not. She said that she would consent to a Care Order if her son was comfortable, happy and safe where he was. She said that she would like to have more regular updates and photographs of her son. She said that she loves her son and would do anything that needed to be done.

The judge said that it must be very painful for the mother to come to court and listen to the evidence. He said that he was also aware that it was largely due to her very sad history and the abuse she suffered having adversely affected her capacity to care for her child and commented that the mother had not received the help she needed. The judge said that the principal reason for making this Care Order is trying to ensure that the boy received the care he needs.

The judge also said that it was unacceptable that the CFA had not kept the mother fully appraised of her son’s progress and said that more than a month should not go by without the CFA updating the mother as to what was happening in the son’s life. He also said that by and large the efforts of the CFA in this case had been productive and he hoped that the CFA would provide the foster parents with the supports they needed. He also noted that he was pleased that a senior psychologist had agreed to oversee the case. In relation to access the judge made no order but said that he hoped that the Care Order would provide some sense of stability for the boy and that access may be reconsidered in the near future. The CFA agreed to organise a psychiatric assessment of the boy and to update the court with the results of the assessment. The judge also directed that an occupational therapy review take place.