Multiple disadvantage: understanding the whole family

Last week the Revolving Doors Research Network published the latest of its series of literature reviews on severe and multiple disadvantage, this time focusing on Understanding the Whole Family. This will be a useful conversation starter to stimulate an increased interest in how much – and how well – we all consider families and relationships in the context of multiple disadvantage.

The review uses a life trajectory format to examine the literature on the role and influence of family life at various stages: in the early years of childhood development, in the context of treatment and intervention, and during the process and maintenance of change. A constant thread is the tension between the family being seen as a cure or a curse, and the difficulty of predicting conclusively one way or the other. On the one hand, the literature can point to trauma, neglect and Adverse Childhood Experiences as a central factor in laying the foundations for an adult life marked by problems like crime, addiction and homelessness. But the family also possesses the key protective factors to prevent the very same problems, and can be turned to to help ‘solve’ such issues later in life by playing a supportive role during drug treatment, or visiting relatives during prison terms.

The review also looks at the issue of intergenerational disadvantage, which is tricky territory, and vulnerable to highly subjective analysis. There are grey areas between people’s identities as victims and as perpetrators – from vulnerable and neglected children to rational adults accountable for their own (sometimes harmful) behaviours, which in turn have a negative impact on their own families and children. The report notes the disproportionate amount of violence perpetrated by men who are themselves in treatment for drug misuse, for example.

As ever, the mistake can come in discounting complexity: in this case, of multiple disadvantage and of family life. The review finds that much of the literature is indeed limited to snapshots, and tends to focus on one problem and how the family relates to it, like the family’s relationship with crime and the criminal justice system. This doesn’t leave much room for analysis of the relationship between individual symptoms and the wider context of related, clustering disadvantage, or space to consider what constitutes ‘family’ in each case.

All families contain both protective and risk factors: they are a source of love, hope and encouragement as well as stress, disruption and pain. Support services can see different perspectives and take different views as to the ‘supportiveness’ or otherwise of the family environment: the refuge may see the violent partner, the drug service may see the supportive grandparent carer, and another agency may see both (or even neither). Individuals are not separable from their experience of family life, and nor are they reducible to it. But as the review notes, at the point of presenting to a ‘service’, policy and practice cannot accurately predict the type of family support needed by an individual. Responses should therefore be able to grapple with complex family dynamics and manage a variety of risks and protective factors from different relationships across different times.

We hope this review will be the start of a wider conversation. Revolving Doors will be hosting a seminar early in the new year to kickstart this – please contact Lucy Wainwright if you are interested in attending.