We spoke to Joanne Greenway, DAISY Service Manager at Walsall Children’s Services, about Walsall’s DAISY Programme.
What is the DAISY Programme?
The DAISY Programme is an intensive attachment based perinatal programme for parents who have had a previous child removed from their care and are currently pregnant. The aim of the programme is to prevent newborn removals by providing intensive intervention and support to parents. The model emphasises attachment and mentalisation based interventions, which helps parents to build parenting capacity by reflecting on and understanding their own childhood experiences, protective strategies, and behavioural patterns. DAISY is a two-year pilot programme, which launched in February 2021. The programme is currently working with 17 sets of parents in Walsall, and sits under social care as part of the Walsall local authority.
History of the Walsall DAISY Programme
The DAISY model was inspired by the Nuffield Family Justice Observatory’s Born Into Care research, which put a spotlight on the rising number of infants in care proceedings in England. Walsall Children’s Services worked closely with Claire Mason, one of the Nuffield researchers, to develop the DAISY programme. The model builds on previous work undertaken by Joanne Greenway and Beverley Barnett-Jones as part of the early Family Drug and Alcohol Court (FDAC) pilot, which was a pre-birth Court Based Assessment Service.
Eligibility and referrals
DAISY staff meet on a fortnightly basis with colleagues working in health and pre-natal care to identify vulnerable Walsall parents who are expecting a newborn, have had a previous child removed from their care, and are willing to work with services. Parents are then invited to participate in an assessment. The offer is extended to both parents, but DAISY will also work with just the mother if the father declines the invitation. Their goal is to start working with parents as early as possible, as the main focus during the initial stage of the programme is to build trust between the parent and the key worker supporting the parent. Because parents participating in the DAISY programme have already experienced care proceedings, many do not enter the programme with a trusting relationship with their local authority and it can take time to establish that trust.
To build a positive relationship, DAISY begins by embracing the network around a family. Often, families have complex needs involving different professionals and services. By bringing everyone together, DAISY builds on practitioners’ collective expertise to evaluate presenting difficulties for a family. Parents are also invited to carry out their own risk assessment. From their perspective, parents are asked: what is causing them the biggest troubles? For the first few weeks, the focus is on fixing the ‘fixable’ problems, or the concrete problems that are solvable in the short-term. Gradually, this builds trust between the key worker and the parent. Once that trusting relationship is established, the programme can begin the deeper work with parents around metallisation and attachment.
The programme and interventions
The DAISY programme involves regular sessions with parents throughout their pregnancy.
Therapeutic work with parents is underpinned by two main theoretical frameworks: the adoptive metallisation-based integrative treatment (AMBIT) model and the dynamic maturational model (DMM). First, the AMBIT approach centres around reflective functioning and emphasises the importance of a whole-team approach for clients presenting with multiple and complex problems. The DAISY programme begins with an AMBIT-informed planning meeting that brings all practitioners involved with the family—including the family, their DAISY key worker, a substance use worker (if applicable), a perinatal mental health worker (if applicable), and anyone else the family wants to bring. Together, they plan for the next four weeks and formulate goals. At every four-week interval, there is an “AMBIT planning meeting” to bring everyone back together to reflect on what is going well and not going well and formulate goals for the next four-week phase. Second, the DMM model underpins work with parents at every stage of the service. The DMM model defines attachment in terms of self-protective strategies, and helps parents make sense of their own behaviours by reflecting on how early exposure to danger may have led to self-protective strategies and behavioural patterns. This intervention helps parents to think about their own life story and go back to their first experiences through a process called “narrative integration.” Once parents have achieved a deeper understanding of themselves, practitioners can start doing targeted interventions around other areas of concern—often surrounding abusive relationships or substance use.
When parents are 35 weeks pregnant, a report is written with the team’s recommendation. The recommendation could be that an infant remains at home with their parent with further assessments whilst the child in the parent’s care; a shared care arrangement between the foster carer and the parent; or a foster care placement. After the child is born, DAISY does a post-birth assessment based on the individual needs of the family. DAISY continues to support the parent for up to 26 weeks after the baby is born, whether the baby is home with their parents or placed in foster care.
Research on DAISY Programme
An evaluation of the DAISY Programme is currently being undertaken by Professor Jane Barlow at the University of Oxford. The programme has garnered national and international interest, and Walsall is already receiving tentative inquiries from other local authorities interested in replicating the DAISY programme.
For more information about this project, please contact: Joanne.Greenway@walsall.gov.uk
This case-study was compiled by Carolyn Lipp in 2022