Touch Guidance

1. Introduction

The term 'Touch' is used throughout this manual in two different contexts.

'Touch' as a form of Physical Intervention designed to prevent a child or others from being injured or to protect property from being damaged; and the use of 'Touch' to enable staff/carers to demonstrate affection, acceptance and reassurance.

This chapter provides guidance on the latter, relating to the demonstration of affection, acceptance and reassurance.

Guidance is provided elsewhere on the use of touch as a form of physical intervention; see Physical Intervention Procedure.

It is acknowledged that touch raises particular issues for those working with children. Staff/carers may be anxious about allegations of inappropriate physical contact with children.

However, touch is acceptable; but staff/carers should consider the following.

2. Appropriate Touch

Close contact and touch are important parts of establishing human relationships. In a general sense, touch can convey warmth; it can divert aggression, and can provide reassurance, care and comfort. Touch can communicate an array of feelings or emotions. However, it can also be used in an oppressive, coercive and punitive manner.

When caring for young people, touch can be present in many forms, including as a result of leisure activities or providing direct physical care.

For looked after children, their experiences can result in the meaning of touch becoming distorted or changed. Many may have experienced inappropriate use of touch and physical contact that staff may or may not be aware of. For some children, physical affection may have previously been linked to sexual activity. Understanding the possible meaning and interpretation of touch in this context can help identify risk and protect both children and carers.

To deprive children of physical contact in order to minimise risk could be damaging in itself, and cause the child to seek reassuring contact in the possibly inappropriate manner they have been used to. Responses need to balance the need for protection with the need to establish a positive caring environment.

Plan In order to care safely and minimise risk, information should be obtained prior to the child's placement so that issues can be identified and strategies planned to manage possible events or difficulties around contact and touch.

Consent Except during Restraint, all physical contact should be with the child's consent.

Location All physical contact must take place in open locations where the contact can be observed or monitored intermittently by people located nearby and who are aware of the interaction. Doors to rooms should be kept open if one to one contact is occurring that could involve physical touch (as long as this maintains individual dignity)

Allegations Children can misinterpret contact or make allegations for various reasons:

• They may link the contact with a past experience;
• The allegation can be a way of obtaining power or control over a situation;
• The child may think making an allegation can help remove them from an unhappy situation or placement;
• Contact may be genuinely misinterpreted.

To minimise opportunity for misinterpretation and false allegations, physical touch such as massage should be avoided. Whilst in some contexts, the use of massage and similar forms of touch are considered positive and therapeutic, when caring for children who have experienced inappropriate or abusive touch, such behaviours can be misinterpreted and at worst provide a 'cover' for inappropriate or abusive touch

3. The Culture, the Boundaries

The culture or values of the home should be such that touch is encouraged as a positive and safe way of communicating affection, warmth, acceptance and reassurance.

Staff/carers and children should be encouraged to use touch, positively and safely.

But it is important for staff/carers and children to know if boundaries exist within the home or for individual children.

If boundaries or expectations exist for individual children they should be set out in their Care Plan, Placement Plan/Placement Information Record or other relevant Plan.

If boundaries or expectations exist for the home, they should be clear. For example, if staff/carers are not expected to allow children to sit on their laps, or to carry children, this should be stated, preferably in writing.

In the absence of any plan or expectation, the following should be taken into consideration

1. When thinking about who is an appropriate person to touch a child, it is vital to consider what the adult represents to the particular child. Personal likes and dislikes will play a part in any relationship;
2. In addition, many factors influence the power relationship between adult and child, including gender, race, disability, age, sexual identity and role status;
3. The background of the child will also influence any decision about who represents a 'safe' adult in the eyes of the child;
4. Children from ethnic minority backgrounds may be used to different types of touch as part of the culture;
5. Children who have been subject to physical or sexual abuse may be suspicious or fearful of touch. This is not to say that children who have experienced abuse should not be touched, it may be beneficial for the child to know different, safer and more reliable adults who will not use touch as a form of abuse;
6. For each child, what constitutes an intimate part of the body will vary; but generally speaking it is acceptable to touch children's hands, arms, shoulders;
7. Other parts of the body are less appropriate to be touched, by degrees. Some parts of the body are 'no go areas';
8. Therefore, it may be appropriate to touch a child's back, ears or stroke their hair or knees - if the child indicates such touch is acceptable. To go beyond this would be unacceptable, even if the child appeared to accept it;
9. In any case, no part of the body should be touched if it were likely to generate sexualised feelings on the part of the adult or child;
10. Also, no part of the body should be touched in a way that appears to be patronising or intrusive;
11. Therefore, the context in which touch takes place is usually a decisive factor in determining the emotional and physical safety for both parties;
12. What message is being sent out to the child? If the intention is to positively and safely communicate affection, warmth, acceptance and reassurance it is likely to be acceptable;
13. In foster care, it may be appropriate to hug or cuddle children, or carry or give them 'piggy backs'. In residential care hugs should be offered only in a sideways manner and kissing is always inappropriate. Sitting alongside a child to offer emotional support is more appropriate than allowing a child to sit on the lap of a member of staff;
14. A fleeting or clumsy touch may confuse a child or may feel uncomfortable or even cause distress. Staff/carers should touch with confidence, and should verbalise their affection, reassurance and acceptance; by touching and making positive comments. For example, by touching a child's arm and saying "Well Done";
15. Where children indicate that touch is unwelcome staff/carers should back off and apologise if necessary;
16. Staff/carers should talk to colleagues and record their interactions with children.  If particular strategies work, or not, colleagues should be informed so they can build on or avoid making the same mistake;
17. Touch of an equally positive and safe nature is acceptable between staff/carers; it demonstrates positive role models for children and shows that adults can get along and use touch in non-abusive or threatening ways;
18. It is also acceptable to talk about how touch feels, about acceptable boundaries and expectations;
19. Play fighting, in the context of caring for children who have had difficult or abusive experiences, should be avoided as it:
    1. Demonstrates and can reinforce an inappropriate model of contact and use of strength and power;
    2. Can confuse and blur the boundaries of appropriate touch;
    3. Can serve as a 'cover' for abusive practice;
    4. Can arouse children sexually;
    5. Can evoke flashbacks for children;
    6. Can marginalise those not involved. If for some children play fighting is the only way they feel able to obtain physical contact, staff/carers should discuss and agree strategies for managing and redirecting the child into more appropriate methods of interaction - i.e. through sporting activities - aiming to phase out the undesired behaviour.
20. All parties should always be appropriately dressed.  Staff/carers should ensure that all children have appropriate nightclothes;
21. The key is for staff/carers to help children experience and benefit from touch, positively and safely; as a way of communicating affection, warmth, acceptance and reassurance.