Diary of a social worker | “Am I 40% less traumatised now, or 40% less important”: The impact of cuts for therapeutic support
I have spent my entire social work career in adoption, kinship and foster care support services in the local authority and voluntary sector, and in recent years as an independent therapeutic social worker. I deliver therapeutic support packages to children who are adopted or live with their Special Guardians, mostly funded by the Adoption and Special Guardianship Support Fund (ASGSF). The ASGSF has undeniably improved access to therapeutic support and benefited many children and their families, but as with everything, there is certainly room for improvement. For example, the fund requires all therapeutic support packages to stop and be reapplied for at the end of March, a process which takes at least five to six weeks, creating a big gap for children requiring ongoing support. Additionally, ever since its establishment in 2015, the ASGSF has only been funded for a few years at a time, creating ongoing uncertainty for both families and practitioners.
The fund was due to end again this March (2025). Confirmation of its continuation arrived late, and since then, significant changes have been announced, including a 40% cut in overall funding. Now that the contracts for continued support packages are finally beginning to trickle in, after a full two-month gap in support, I am starting to see the immediate impact of the cuts. The therapeutic time which in previous years covered more or less a year’s worth of fortnightly sessions has been reduced so much, that fortnightly sessions would now not get us beyond Christmas.
I spend every first session after the long gap having difficult conversations as I talk families through their options: shorter sessions, fewer sessions, or bigger gaps between each time we meet. Most choose shorter sessions. The first few shorter sessions feel like we are all on our best behaviour; careful not to digress too much, not to waste any of the precious little time we have. I reflect on all the insights families gained over the years while digressing and resolve to find ways to stop thinking about the ticking clock.
I reflect with a parent on how their very active and anxious child seems to need at least half an hour to settle into sessions. We wonder how we can make the shorter time work for them. “We’ll just have to do the best we can”, I’m surprised to hear myself say. I feel the weight of the importance of this work: to help children who have been through so much to have more ease in their daily lives, to feel happiness more often. “Just doing the best we can” doesn’t seem enough.
Many years ago, when I did my Dyadic Developmental Psychotherapy (DDP) training, Daniel Hughes (who created DDP), questioned why I was seeing a young person only once every three weeks. “How much can you water this down before there is no point in doing it anymore?” he asked, kindly. His words keep going through my mind these past few weeks. How can we do justice to therapeutic interventions (such as DDP, Theraplay, Eye movement desensitization and reprocessing and Therapeutic Life Story Work) with such limited time available?
The young people themselves are mostly pragmatic about the changes. I worry that this feels like yet another one of the many experiences they have had where professionals make big decisions about their future, often without consulting them. One teenager says that there are also cuts at their school; some school staff have taken voluntary redundancy and won’t be replaced. They muse that it doesn’t feel like their generation is a priority. Another asks whether I would still do this job if I didn’t get paid. We share a laugh about me waiting on a park bench for people to share their innermost thoughts with me, but I do understand the underlying sentiment of the question: “This makes me feel like you don’t really care about me, like it’s just about money”.
The following day, I discuss priorities for the coming year’s therapeutic support with another teenager. They experience significant emotional distress, which at times results in risky behaviours. When we started working together last year, they felt guilty for taking up therapy time. It took quite some convincing that the ASGSF was there for them, in recognition of the long-term impact of what happened in their early lives. Now, as we mention the cuts, they wonder: “Am I 40% less traumatised now, or just 40% less important?”
I notice that the new contracts prioritise therapeutic time, with minimal time set aside for reviews, reports and liaison. I worry that this may lead to reduced communication between professionals and, potentially, dangerous situations. I think about all the case reviews which recommend more communication, not less. I wonder if the people behind these cuts truly realise the complexity of the needs of some of the children and families we work with, and the risks involved? Do they fully understand the potential impact of the children’s experiences with their first parents, their losses, the impact on their identity and self-esteem, and, particularly in kinship families, the challenging (wider) family dynamics?
My work has always included a lot of therapeutic parenting support, alongside family sessions and individual work with children. Many parents and carers now feel they have to choose between support for their children or for themselves. Unsurprisingly, most prioritise support for their child. However, parenting support is not just helpful for the adults. This is very clear in my area of specialism, child to parent violence and aggression. For many of the families I work with, parenting support is vital for the stability and sustainability of the family.
Parents and carers are the child’s most important resource, and the emotional health of the family system depends on them. I worry that these cuts will result in more adoption and placement breakdowns, and more children going back into care, a concern echoed by, the head of Adoption England, Sarah Johal in her recent interview with Community Care. Some parents and carers have already said that they are willing to self-fund parenting work, but I am acutely aware that this is not a realistic option for everyone. I feel very uncomfortable about the prospect of some children having greater access to therapeutic support than others, depending on the financial position of the family they are placed with, something which seems to go against all recent policies.
Due to children’s complex early experiences, building a trusting relationship can take a considerable time. I haven’t yet started any new cases since the announcement of the cuts, but I am already thinking about how to make sure that by the end of a much-reduced package of support, each family still feels that we have developed a positive working relationship, and that they are in a better position than before. This will be especially important if they may then need to wait several months for next year’s funding to continue the work (presuming the ASGSF is continued in one form or another next year).
As disappointing and frustrating as these cuts are, I know that as social workers we will strive to rise to this challenge. This is what social workers excel in. We have always strived to do more than what seems possible with limited resources, under ever changing circumstances. I spend my evenings looking at time-limited approaches, to see what I can learn from them. I’m also exploring ways to divide interventions such as therapeutic life story work into separate phases, to ensure safety and effectiveness if we need a longer break between support packages.
However, the creativity, flexibility (and, realistically, hours of unpaid work) that practitioners in the field will undoubtedly bring to this new challenge should not be mistaken for evidence that the reduced funding can adequately meet the needs of kinship and adoptive families. ASGSF funded interventions were never meant as crisis support, but now more than ever CAMHS, the NHS and local authority services need to be ready to pick up the pieces where ASGSF funded therapeutic support is unable to address complex, long-term needs. We need to be realistic about what we can and cannot achieve, while continuing to do our very best with what is available. Funds are limited in many areas, but the children I work with are no less important and, sadly, no less traumatised than before.
Hedwig Verhagen, Therapeutic Social Worker.