Care workers must learn to be more assertive

SECOND OPINION: Vital lessons to be learned from the Roscommon case, writes JACKY JONES

SECOND OPINION:Vital lessons to be learned from the Roscommon case, writes JACKY JONES

THERE IS an aspect of the Roscommon childcare case which has received no media coverage and yet, as a society, we have to analyse and understand it if we hope to deal more effectively with children’s needs in the future. This is referred to in the report by the inquiry team as a lack of HSE “worker assertiveness”. Why are professional people with the benefit of a third-level education and the statutory powers to bring about change so singularly unable to assert their authority?

It is quite clear from every page of the report that the parents in the Roscommon case ran rings around all the HSE staff involved. To use some descriptions from the report, the parents were devious, manipulative, deft and able to stage manage and orchestrate things to their own advantage.

How can this happen? A consistent feature of all of the cases of child abuse reported on in Ireland in the past 20 years at least, have one thing in common – there is a controlling malevolent male figure at the centre. This is true of all cases involving families and also cases involving the Catholic Church. These criminals and child rapists have an arrogance and a belief that they can do what they like and neither authority figures nor the State can stop them.

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HSE staff and others dealing with child abuse cases have to be assertive and be able to deal with bullying, aggression and manipulative behaviour. They are clearly not able to do this – as is highlighted in the Roscommon case – and it is interesting to speculate as to why this might be.

Irish people are, in general, very unassertive. While we might be amused at our reluctance to complain about a meal in a restaurant, our lack of assertiveness has much more serious consequences for our health and wellbeing. Apart from society’s response to child abuse, our lack of assertiveness also shows itself, for example, in elder abuse where older people are unable to stand up to bullying relatives.

We might expect professional people to be more assertive than the general public, but this is not the case. Between 1987 and 1997, before I became a manager, I ran assertiveness courses for a wide variety of groups including school inspectors, principals, teachers, nurses and ordinary members of the public. These groups had identical problems in being assertive with their relatives, work colleagues and clients. Seniority and qualifications made little difference to their ability to be assertive.

Fear is behind our lack of assertiveness. We learn to be unassertive in childhood – instead responding to situations aggressively, as a doormat, or by manipulating others. We are afraid of confronting difficult situations because of fear of the possible negative consequences. What we forget as adults is that we can control these consequences, whereas we couldn’t as children. We do not have to spend our lives pleasing and placating those around us and not standing up for our own rights.

The assertive response of HSE workers in the Roscommon case should have been, “This is what we are doing regardless of anything you, the parents, say and this is what will happen”. Sticking to that plan of action like a “broken record”, which is an assertiveness skill, would have made a difference to the children.

HSE childcare workers require training in assertiveness, according to the report. Effective training of this kind requires 25-30 hours, and it is difficult to see how this can be achieved given that one of the cuts in the HSE for 2011 is a 50 per cent reduction in training. The good news is that new performance indicators (PIs) on child abuse and neglect were introduced in the 2010 business plan for the first time and will be reported on for this year.

However, PIs will make no difference to future cases unless HSE staff learn to assert themselves with parents and others who have abdicated their responsibility for the care of children and hence any authority they might assume themselves to have over their children.


A free HSE manual on assertiveness training is available from Eileen Holland, Health Promotion Department, HSE West, at 091-548321 or eileen.holland@hse.ie


Jacky Jones is a regional manager of health promotion with the HSE.