In this article
A child psychologist is a mental health professional who uses psychological evaluations and various forms of therapy to help children and young people learn to better cope with life and relationship issues and mental health conditions. Child psychologists also share a responsibility with all other members of the healthcare professions for the safety and wellbeing of all clients and their protection from harm, abuse, exploitation or unsafe practice.
What is safeguarding?
Child psychology services and education psychology services can support children who have been abused. They can work with children and young people to support their development, welfare, resilience, learning and achievement. Child protection and safeguarding are important aspects of work for all professionals working with children, and this work includes partnerships with a wide variety of other professionals. Children, however much we would like to think that they are happy and contented and without fear, can face the same trials and tribulations as adults and indeed can sometimes be far more susceptible to psychological and behavioural disorders than adults. Child psychologists can do much to disseminate and use psychologically informed evidence to safeguard children and young people, and to help those who have suffered abuse and its consequences.
Safeguarding means protecting people from harm including physical, emotional, sexual and financial harm and neglect. Child psychologists have a duty to recognise the signs and symptoms of abuse and to act on any concerns. Duties to safeguard children and young people are required by professional regulators and service regulators and are supported by law.
A child means anyone aged under 18 years, or under 25 years if they have special educational needs or disability (SEND).
Safeguarding children and young people’s welfare are defined in “Working Together to Safeguard Children” as:
- Protecting children from maltreatment.
- Preventing impairment of children’s health or development.
- Ensuring that children grow up in circumstances consistent with the provision of safe and effective care.
- Taking action to enable all children to have the best outcomes.
The Care Act 2014 lists six key principles of safeguarding. These are intended to form a core set of standards for anyone who has a responsibility for safeguarding. Although these principles have been designed with a focus on vulnerable adults, they should be applied to any type of vulnerable individual, children included.
The principles are as follows:
- Accountability – in the event of a disclosure, if an adult, child or young person entrusts you with information that you know could be indicative of abuse, you must be clear with the individual that you need to report what you have heard.
- Empowerment – it’s important for any person who has been a victim of abuse to feel that they have control over their situation. Support and encouragement are key to effective working with a victim of abuse or neglect.
- Partnership – it is important to work in partnership with your local authority and all services or organisations in your community that might be able to assist in detecting and reporting abuse.
- Prevention – it is sometimes possible to take action before harm has come to an individual. If you know the signs and indicators of abuse, you will understand when something is not quite right and will be better placed to report any concerns for an individual’s wellbeing.
- Proportionality – when a safeguarding incident occurs, you should report your concerns in a manner that is appropriate for the risk presented. For example, if you suspect that a child is in immediate danger, dialling 999 is the recommended response.
- Protection – it is crucial to be an ally for individuals who have experienced or who are at risk of abuse. Supporting and representing these individuals in the appropriate manner can help to protect them from further harm.
What risk factors make someone more likely to experience abuse?
Abuse and neglect can occur anywhere to anyone.
Any child or young person can be at risk of abuse; however, there are a number of factors that can increase their vulnerability to abuse and neglect including, but not limited to:
- Very young children.
- Children with disabilities and health problems.
- Socioeconomic factors such as poverty, poor housing and deprivation.
- Family factors such as parental/carer substance misuse problems, parental/carer mental health problems and domestic abuse. These factors may be compounded if the parent/carer lacks support from family or friends and experiences social isolation.
- Children who do not live with their families of origin.
- The parent or carer does not engage with services.
- There have been one or more previous episodes of child abuse or neglect.
- The parent or carer has a mental health or substance misuse problem which has a significant impact on the tasks of parenting.
- There is chronic parental stress.
- The parent or carer experienced abuse or neglect as a child.
- A family history of maltreatment.
- A non-biological adult living in the house.
- Being in care, a looked-after child.
- Children who have a history of offending, either parent or child.
- Children who have a learning disability (SEND).
- Children who suffer from drug or alcohol problems or whose parents do.
- Children who have low self-esteem.
- Children who have communication difficulties.
- Children who identify as LGBTQ+.
This list is not exhaustive, and other children or young people might also be considered to be children at risk.
The types of abuse children can encounter
Statutory guidance across the four countries of the UK describes four main categories of child abuse, and these definitions will normally be reflected in local organisations’ policies and procedures.
The four categories are:
- Physical harm/abuse – this may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child/young person. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child/young person. Harm can also occur due to practices linked to faith and culture, for example, Female Genital Mutilation (FGM).
- Emotional harm/abuse – this is the persistent emotional maltreatment of a child/young person such as to cause severe and persistent adverse effects on the child/young person’s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child the opportunities to express their views, deliberately silencing them or “making fun” of what they say or how they communicate. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capacity, as well as overprotection and limitation of exploration and learning, or preventing the child from participating in normal social interaction. It may involve seeing or hearing the ill treatment of another. It may involve serious bullying, including cyberbullying, causing children/young people frequently to feel frightened or in danger, or the exploitation or corruption of children/young people. Some level of emotional abuse is involved in all types of maltreatment of a child/young person, though it may occur alone.
- Sexual abuse – this involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetrative acts, for example rape or oral sex, or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may include non-contact activities, such as involving children in looking at, or in the production of, pornographic sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse, including via the internet. Sexual abuse is not solely perpetrated by adult males; women can also commit acts of sexual abuse, as can other children.
- Neglect – this is the persistent failure to meet a child/young person’s basic physical and/or psychological needs, likely to result in the serious impairment of the child/young person’s development. Neglect may occur during pregnancy, for example as a result of maternal substance abuse, maternal mental ill health or learning difficulties or a cluster of such issues. Where there is domestic abuse and violence towards a carer, the needs of the child may be neglected. Once a child is born, neglect may involve a parent or carer failing to:
– Provide adequate food, clothing and shelter, including exclusion from home or abandonment.
– Protect a child/young person from physical and emotional harm or danger.
– Ensure adequate supervision, including the use of inadequate caregivers.
– Ensure access to appropriate medical care or treatment, and also include neglect of, or unresponsiveness to, a child/young person’s basic emotional needs.
What safeguarding issues do child psychologists need to be aware of?
Abuse may be deliberate or as a result of lack of attention or thought, and may involve combinations of all or any of the above forms. It may be regular or on an occasional or single event basis; however, it will result in some degree of suffering to the child or young person concerned.
Indications might include, but are not limited to:
- Domestic violence – this is a safeguarding matter when the adults experiencing domestic violence have children or there are children in the house. Incidents or patterns of controlling, coercive, threatening, violent or abusive behaviours can impact on the care of children and the capacity of the adults concerned to safeguard children.
- Physical signs such as hand-slap marks, bruising in unusual areas, bruised eyes and bite marks.
- Deliberate self-harm and/or drugs and alcohol misuse.
- Child sexual exploitation – this involves situations, contexts or relationships in which a person under 18 is given something, such as food, accommodation, drugs, alcohol, cigarettes, affection, gifts or money, in return for performing sexual activities or having sexual activities performed on them. It can also involve violence, coercion and intimidation, with threats of physical harm or humiliation.
- Poor physical care and inadequate hygiene, inappropriate dress.
- Talking about being left home alone, with inappropriate carers or with strangers.
- Child criminal exploitation – this is child abuse where children and young people are manipulated groomed, exploited and coerced into committing crimes. A child or young person might be recruited into a gang because of where they live or because of who their family is. They might join because they don’t see another option or because they feel like they need protection. Children and young people may become involved in gangs for many reasons. Organised criminal gangs groom children and young people because they are less suspicious and are given lighter sentences than adults.
- Peer-on-peer abuse – this is a term used to describe children abusing other children. Peer-on-peer child abuse can include: bullying including online bullying and bullying because of someone’s race, religion, sexuality, disability or trans status, and abuse by a girlfriend, boyfriend or partner.
- Female genital mutilation – this is when a female’s genitals are deliberately altered or removed for non-medical reasons. It is also known as female circumcision or cutting, but has many other names. A child who has faced or is worried about FGM, might not realise what’s happening is wrong. Girls living in communities that practise FGM are most at risk. It can happen in the UK or abroad.
The roles and responsibilities of a child psychologist in regard to safeguarding
Safeguarding children and young people is everyone’s responsibility and child psychologists will have an individual responsibility to safeguard children and young people in their care, to identify and respond to allegations of abuse and neglect. Child psychologists should act as an effective advocate for the child or young person, proactively seeking the child’s views but also considering how to balance children’s rights and wishes with a professional responsibility to keep children safe from harm.
Health services including child psychologists have a duty to safeguard all clients, but also to provide additional measures for clients who are less able to protect themselves from harm or abuse. Safeguarding children covers a spectrum of activity from prevention through to multi-agency responses where harm and abuse occurs. Multi-agency procedures apply where there is concern of neglect, harm or abuse to a patient defined under the Care Act (2014) guidance as vulnerable.
A child psychologist’s role in child safeguarding is to:
- Recognise – you should have a clear understanding of what the different signs and symptoms of potential abuse, harm and neglect can be. Robust safeguarding training can help you to spot these signs and symptoms.
- Respond – it is essential that you respond appropriately and do not ignore the situation.
- Report – concerns need to be reported without delay. Confidentiality is important, so only share information with those who are a part of the safeguarding process.
- Record – you should make precise, comprehensive notes that detail everything about your safeguarding concern.
- Refer – if the safeguarding risk is urgent and you suspect somebody is under immediate or severe threat, you should contact the relevant local authority or police services.
Child psychologists have a duty to make sure that:
- Safeguarding concerns are dealt with promptly, appropriately and reported in a secure and responsible way to all relevant agencies.
- Steps are taken to escalate or alert those able to protect clients and/or other children at risk from harm and minimise the risk of abuse.
- Appropriate and proportionate measures are in place to protect from harm all those who work for them, or with them, or come into contact with them.
People aged 16 or over are entitled to consent to their own treatment. Children under the age of 16 can consent to their own treatment if they are believed to have enough intelligence, competence and understanding to fully appreciate what is involved in their treatment. This is known as being Gillick competent. Child psychologists may find it difficult to accept the client’s choices such as declining services or acting against advice about how to manage their safety. They may be concerned that they are failing in their duty of care and that they could be found to be reckless or negligent. A duty of care is a requirement placed on an individual to exercise a reasonable standard of care while undertaking activities or omissions that could foreseeably harm others. However, duty of care also includes respecting the person’s wishes and protecting and respecting their rights.
The safeguarding issues child psychologists may come across
Understanding what abuse and neglect might look like and how to recognise warning signs is an important aspect of safeguarding.
Some examples child psychologists might encounter may include, but are not limited to:
- Many children, for example, suffer the effects of bullying at school but may never tell their parents. Many children see their bullying as a sign of weakness and telling a parent only makes these feelings manifest themselves ten-fold.
- Working with vulnerable young people who may have multiple and chronic problems, including mental health issues, learning difficulties or substance misuse.
- A child’s behaviour may indicate that they have been abused. The child may show fear of adults or a fear of certain adults when they approach them, or display aggressive behaviour, or be excessively withdrawn, fearful or anxious about doing something wrong.
- A disclosure made by a client of historical allegations of abuse, particularly of sexual abuse, which may mean the alleged abuser is continuing to harm other children.
- Internet abuse, which can involve cyberbullying, exposure to pornography or violence and exploitation of children or young people.
- Self-harm and self-neglect – signs of self-harm might not always be visible but changes in mood and behaviour might be a sign of depression.
- The persistent emotional maltreatment of a child or young person such as to cause severe and persistent adverse effects on the child’s or young person’s emotional development. It may involve conveying to a child or young person that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person.
- Missed appointments may be an alerting feature that a child or young person is being neglected or has been seriously harmed by maltreatment.
Where should child psychologists go with a safeguarding concern?
Some concerns may be minor in nature but provide an opportunity for early intervention, for example advice to prevent a problem from escalating. Other safeguarding concerns may be more serious and need a response through multi-agency procedures and possible statutory intervention through regulators, the criminal justice system or civil courts.
Child psychologists can work in schools, research centres, clinics and hospitals, so immediate concerns about abuse or neglect should be dealt with under local safeguarding procedures first. You have a responsibility to formally inform and consult the designated safeguarding lead in that setting at the earliest opportunity. The designated safeguarding lead will normally be someone who has been given special responsibility and training in dealing with employees’ concerns.
The role includes:
- Making sure appropriate systems for raising concerns are in place and that all staff can access them.
- Making sure staff can see all concerns are taken seriously, even if they are later seen to be unfounded.
- Investigating concerns promptly and including a full and objective assessment.
- Taking action to deal with the concern and record and monitor this action.
- Keeping the employee who raised the concern up to date with what is happening.
- Having processes in place to support employees raising concerns.
- Having a role in highlighting learning and which may facilitate or be part of learning events.
The person who raises a safeguarding concern within their own organisation should follow their organisation’s policy and procedures. This concern may result from something that you have seen, been told or heard. You don’t need to have all the facts to prove your concern, but you must have a reasonable belief that wrongdoing is either happening now, took place in the past, or is likely to happen in the future.
Should you continue to have a well-reasoned concern which has not been taken up by the setting in which you are working, you should take responsibility for reporting your concern to the relevant authority. Speaking up on behalf of people in your care is an everyday part of your role. Just as raising genuine concerns represents good practice, doing nothing and failing to report concerns is unacceptable.
If you witness or suspect that there is a risk of immediate harm to a person in your care, you must act straight away to protect their safety. You should report your concerns to the appropriate person or authority immediately; this may be the police in some situations. Involvement of the police is indicated in incidents of suspected theft and common assault, including sexual assault, and assault causing actual bodily harm. However, the police may also be involved in other safety incidents such as wilful neglect of a person lacking capacity.
In all cases full notes should be taken of your decision, actions and reasons for them.
What legislation do child psychologists have to follow in regard to safeguarding?
In the UK, people working in children’s health services have a duty under section 11 of the Children Act 2004 to ensure that they consider the need to safeguard and promote the welfare of children when carrying out their functions.
Working Together to Safeguard Children 2010 – the way that agencies and organisations should work together to carry out their duties and responsibilities under the 1989 Children Act and other legislation is set out in a document called ‘Working Together to Safeguard Children’.
It sets out the responsibilities of all agencies in the protection of children, and is aimed at staff in organisations that are responsible for commissioning or providing services to:
- Children, young people and adults who are parents/carers.
- Organisations that have a particular responsibility for safeguarding and promoting the welfare of children and young people.
The Care Act 2014 sets out statutory responsibility for the integration of care and support between health and local authorities. NHS England and Clinical Commissioning Groups are working in partnership with local and neighbouring social care services. Local Authorities have statutory responsibility for safeguarding. In partnership with health they have a duty to promote wellbeing within local communities.
Safeguarding Vulnerable Groups Act 2006 and the Protection of Freedoms Bill – this Act was passed to help avoid harm, or risk of harm, by preventing people who are deemed unsuitable to work with children and vulnerable adults from gaining access to them through their work. Organisations with responsibility for providing services or personnel to vulnerable groups have a legal obligation to refer relevant information to the Disclosure and Barring Service (DBS).
GDPR and information sharing – all child healthcare professionals and agencies have a responsibility to inform child social care and to share information with other agencies if they are concerned that a child is in need or at risk of harm. Good practice shows that they should always discuss this with the parents/carers and the child, if they have sufficient understanding. However, if you are concerned that this could increase risk to the child, you should share their information and get advice from child social care services. You may need to pass on information without the consent of the family if you think it is necessary to protect the child.
The Public Interest Disclosure Act 1998 – this Act, often referred to as the Whistleblowers Act, encourages staff to report suspected wrongdoing and protects those that do against being dismissed or suffering a detriment by their employers. It also gives protection to employees against suffering a detriment or retaliation from another employee for reporting suspected wrongdoing.
The Human Rights Act 1998 applies to anyone whose care or treatment is funded or provided by a public body. Section 6 requires all public authorities to act in ways that are compatible with human rights when making decisions.
The Terrorism Act 2000 makes it a criminal offence for a person to fail to disclose, without reasonable excuse, any information which they either know or believe might help prevent another person from carrying out an act of terrorism or might help in bringing a terrorist to justice in the UK.
Why is safeguarding training important?
It is important that we all understand safeguarding, and know what to do should safeguarding concerns arise.
Safeguarding induction and training is essential for all child psychologists appropriate to their role, including:
- Information on types of harm, abuse and neglect.
- How to spot abuse.
- How to respond to concerns.
- Who to report concerns to.
Training should be directly applicable to the responsibilities and daily practices of the person being trained, and to the care and support needs of the individuals that they are working with. An example of appropriate safeguarding training includes Safeguarding Children Level 2, designed for people who are working with children and teaches the skills needed to safeguard children who are at higher risk of abuse is recommended for child psychologists who have regular contact with families and children as part of their role.
Other training that is recommended for child psychologists to provide the skills and knowledge for effective safeguarding include, but are not limited to:
- Domestic Violence Awareness
- Substance Misuse Awareness
- Modern Slavery Awareness
- Adolescent Mental Health Awareness
- Self-Harming Awareness
- Suicide Awareness
- Prevent and Radicalisation
- Child Criminal Exploitation and County Lines
- Understanding Bullying
A child psychologist’s supervisor should evaluate changes in understanding and confidence of a child psychologist before and after training, assessing this:
- Immediately after the training.
- In regular long-term evaluations, for example as part of supervision sessions.
- Annually, for example as part of the performance management/appraisal process.
Supervisors should provide feedback through supervision and appraisals, acknowledging how the child psychologist has learned from their experience of identifying, reporting and managing safeguarding concerns.
How often should child psychologists renew their safeguarding training?
Supervisors should assess a child psychologist’s safeguarding knowledge annually, and run refresher training if needed. To help child psychologists increase their confidence in managing safeguarding concerns, they should at a minimum refresh their safeguarding training at least every 2 years and participate in continuing professional development (CPD).