Mechanisms for Support: A Realist Evaluation of Peer Parental Advocacy in England

Abstract

International research shows that although parents perceive the child protection system to be stigmatising and authoritarian, peer parental advocacy (PPA) programmes have a positive impact on improving complex relationships between parents and professionals. PPA programmes enable parents with lived experience of child protection processes to support other parents to navigate the system. As an emerging area of policy interest, research investigating the role of PPA in empowering parents to participate meaningfully in decision-making is crucial to developing collaborative approaches within child protection social work. This realist-informed study considered how a newly implemented PPA programme supported parents in two English Local Authorities. Our findings highlight the unique role peer advocates can play as a resource to influence decision-making, power relations and working relationships between professionals and parents. This article presents our final programme theory, which identifies four key mechanisms that support perceived effectiveness in PPA implementation: active engagement, effective communication, facilitating trust and adequate support for advocates. These findings highlight how PPA programmes in these Local Authorities were valued and begin to build a picture of how further advocacy programmes can be explored throughout the UK.

Introduction

Engagement in child protection services involves the active collaboration of parents with professionals in decision making and is a critical component of effective social care practice by taking all perspectives and needs of the parties into account. However, the authoritarian nature of child protection conferences (CPCs) and the power imbalance between parents and professionals can leave parents feeling disempowered and oppressed (Gibson, 2017; Muench et al., 2017), contributing to a cycle of distrust and poor relationships between families and social workers (Featherstone et al., 2018; Diaz, 2020). The Independent Review of Children’s Social Care (IRCSC) in England drew a link between engaging parents effectively and positive and safe outcomes for families. It recommended that parents whose children were open to children’s social care (CSC) are offered parental advocacy, recognising its potential to support parents in navigating the child protection process (MacAlister, 2022).

To address these systemic concerns, the IRCSC highlighted parental advocacy as an innovative practice as a means to support parents. International research has identified peer parental advocacy (PPA) as an intervention that can support parents to participate meaningfully in decision making and give a voice to parents who otherwise may have remained unheard. This can have a positive impact on child and family outcomes including safely reducing the number of children entering state care (Cohen and Canan, 2006; Tobis et al., 2020). Research shows that PPA promotes collaborative decision making between social workers, parents and other professionals, improving relationships (Rockhill et al., 2015; Trescher and Summers, 2020). However, there remains a limited evidence base around the efficacy of these programmes in the UK, highlighting the need for in-depth evaluations of mechanisms for effective implementation of PPA interventions.

Three forms of parental advocacy have been identified including case, programme and policy advocacy (Tobis et al., 2020). This evaluation focuses on case advocacy in the form of PPA programmes, whereby parents with lived experience of child protection support parents currently navigating CPCs with the aim of increasing parent participation in decisions relating to child. Often in case advocacy, the shared experience of social care intervention enables peer advocates to empathise and relate to parents, creating a unique relationship underpinning support (Tobis et al., 2020). Programme advocacy involves parent advocates supporting the design, delivery and evaluation of programmes, whilst policy advocacy involves parents instigating political change in social care, participating in governmental and non-governmental advisory boards and working at the grassroots and community levels to advocate for reform.

This article presents findings from a realist-informed evaluation of newly implemented PPA programmes in two English Local Authorities (LAs). It explores the perceived effectiveness of advocate support and its relationship with intended and observed outcome patterns as identified by parents, peer advocates and social care professionals. It focuses on the subjective views of participants about the perceived effectiveness, impact and outcomes of the advocacy programme. Observed outcome patterns of interest include improved parental awareness of available resources and services, increased decision-making power and confidence, a better understanding of complex social work processes and increased trust in the system and its workers.

Research design

Methodology

This study employs a realist approach, which aims to explain the underlying cause or mechanisms underpinning the observed phenomenon. It involves iterative theory development based on identifying specific contexts and generative mechanisms associated with an intervention (Pawson and Tilley, 1997; Dalkin et al., 2015). The context–intervention–mechanism–outcome (CIMO) configuration is used to develop the resulting programme theory. Context refers to a combination of individuals, relationships, settings and infrastructure where programmes are introduced (Pawson and Tilley, 1997). The intervention (here referring to the PPA programme) triggers context-specific mechanisms, which refer to the resources, reasoning and perceptions of the recipients and contributors to the programme (Higgins et al., 2015). Mechanisms, when activated, produce specific intended or unintended outcomes. By engaging with the CIMO configuration, we can explore the mechanics of the programme and its relationship with mechanisms and outcomes.

Realist methodology is well-suited for exploring the complexities of interventions within child protection, generating a deeper understanding of contextual factors and associated generative mechanisms. It combines resources (the PPA programme) and structural and individual reasoning to understand how effective PPA implementation can create a facilitative context for parental engagement and collaboration. This approach goes beyond assessing whether the intervention works, to understanding how and why it works in specific contexts, which is valuable when working with complex interventions such as PPA, where factors and generative mechanisms can influence outcomes.

The CIMO configuration informs the programme theory, a conceptual framework that explains how an intervention works by identifying the underlying mechanisms that produce observed or intended outcomes in a given context. Though the overall programme theory explains the complex interplay between the PPA intervention, its context and the perceived outcomes it produces (Diaz et al., 2023), this article focuses on four key mechanisms identified as supporting effective advocacy, rather than the programme theory as a whole.

We aimed to use this methodology to address the following research questions:

1. What are the key ingredients of the PPA service in two LAs?

2. What are parents’ and professionals’ experiences of the PPA service?

3. What potential impacts (both positive and negative changes) do parents and professionals who work with PPAs identify?

Data collection and analysis

Study sites

Fieldwork was conducted in two English LAs, selected for being amongst the first to establish a PPA service in England, funded by the LA. Both are inner-London boroughs with mixed levels of deprivation and diverse populations. The PPA programmes were implemented similarly in both LAs providing support primarily within the context of CPCs. Peer advocates in both LAs are required to have lived experience, as a parent, of CSC. In LA1, peer advocates complete an accredited qualification in parent advocacy, incorporating a range of formal training sessions, essays and reflective work. The advocates are supported by Family Group Conference (FGC) coordinators with experience of parent advocacy in child protection work. In LA2, parent advocates complete an eight-week training course, including an accredited advocacy skills module. Parent advocates receive regular individual and group supervision whilst engaging in the advocacy role.

Data collection

We conducted semi-structured interviews with seven parents, six peer parental advocates, four senior managers and four social workers across the two sites. Additionally, we conducted two focus groups (twelve parents and twelve peer parent advocates, including those interviewed individually), two stakeholder meetings and five observations of CPCs. The LAs and peer advocacy services acted as gateways for recruitment. Initial contact was made with the LA lead and advocacy service and participant information sheets were disseminated to potential participants by the LA. Potential participants could ‘opt in’ by contacting us if they wished to participate in the research.

The choice of data collection methods was designed to co-produce a programme theory with stakeholders with a range of experience in order to meaningfully contribute to our understanding of the effective implementation of PPA programmes. The decision to hold both focus groups and interviews was in part pragmatic, based on the availability and preferences of participants. A combination of interviews and focus groups was also preferable for methodological reasons. Interviews provided an in-depth exploration of individual experiences and perspectives, which provided rich and detailed data on the intervention. The focus groups, in contrast, allowed for a broader exploration of shared perspectives, resulting in a more nuanced understanding of the issues and the intervention in developing the programme theory.

Sampling

Participants were selected via purposive sampling techniques, which allowed for the inclusion of individuals best placed from whom to gather rich data in order to address the study objectives (Patton, 2002). Although this sampling frame is subjective and potentially vulnerable to researcher bias limiting how representative inferences may be (Etikan, 2016), it is particularly efficient for small-scale studies as it targets individuals with relevant experience and expertise (Denscombe, 2017). Participant criteria included parents who had been supported by parental advocates, peer parental advocates and FGC co-ordinators supporting parents and senior managers and social workers involved in the PPA programme. Recruitment was based on the developing programme theory with individuals selected on their potential to shed light on gaps in understanding in the intervention. This evaluation consisted of six project stages within two phases (see Table 1) leading to the final programme theory.

Data processing

Interviews and focus groups were transcribed smart verbatim and analysed using computer-assisted qualitative data analysis (NVivo 12 Plus). An inductive approach was used to identify recurrent themes resulting in an initial framework of seventy-four codes. These were refined into categories and used to build the initial CIMO configurations and initial programme theory (IPT). Themes were then explored iteratively with parents, peer parental advocates and professionals to develop the final programme theory.

The final programme theory addresses the following objectives:

• To understand how peer parental advocates are perceived to impact decision making, power relations and relationships between parents and professionals involved with child protection services.

• To identify potential impacts (positive and negative) on advocacy for parents and outcomes for children and families.

• To develop a programme theory that identifies enabling mechanisms that could be used to support future service delivery.

Ethics

We obtained ethical approval from Cardiff University’s ethics committee and we reflected on ethical considerations throughout the study. This ensured appropriate consideration of confidentiality, informed consent, data protection and protection from harm. Particular consideration was given to the participation of parents whose engagement with child protection services may be particularly stressful or upsetting. Prior to and throughout each interview, focus group and stakeholder meeting, participants were given the opportunity to ask questions and were informed of their right to decline to answer specific questions and withdraw from the study at any point. We also offered support and signposting to appropriate services.

Discussion of findings

We aimed to understand how PPA programmes work and were implemented in the two LAs by developing the programme theory and mapping mechanisms. We explored how PPA is perceived to influence decision making, power dynamics and relationships between social care professionals and parents. The following section briefly outlines the stages of the PPA intervention that informed our IPT and provides an overview of the findings and mechanisms derived from it.

Exploring the intervention

Three intervention stages were identified in our research: pre-advocate involvement; during advocate involvement and ongoing support. This article focuses primarily on the pre- and during-involvement stages of PPA intervention (see Figure 1).

Pre-advocate involvement

Stage 1 refers to pre-advocate involvement or the period before advocates actively begins engaging with parents. Before the PPA actively begins supporting parents, they require a period of formal training. This training covers the remit of the role, managing emotions and exploring the goals of advocacy work. Parents are informed about the role of PPAs by their social worker and given the option to request one. This stage also involves ensuring that the right parent advocate is paired with the right family. This research has particularly highlighted that the needs of parents are very diverse and that the role of the PPA has become increasingly multifaceted.

During advocate involvement

The second stage involves advocates working with parents during the CPC process. At this stage, a peer advocate is assigned to a parent, and plays a critical role in helping them understand the child protection process, professionals’ roles and expectations of CPCs. The advocate also provides emotional support, clarifies language and terminology, and ensures parents can express their wishes and challenge processes. The peer advocate’s lived experience can help them to empathise with parents and ensures they are not perceived as simply ‘another professional in the room’. The PPA acts as a bridge between parents and professionals, facilitating communication, empowering parents to make their voices heard and supporting them to play a meaningful role in decision making. Regular supervision is provided to the parent advocate, offering practical and emotional support, to identify training needs and concerns early on.

Ongoing support stage

Finally, the third stage involves an ongoing, iterative support phase. Following active collaboration between parents and PPAs, peer advocates provide ongoing support to ensure that parents continue to feel supported and heard. The advocates receive ongoing supervision and support, and upon completion of the work, their involvement is evaluated. PPAs are paid for their work, which is perceived as critical to ensure that their lived experiences and unique contributions are valued and respected.

The three stages of the PPA intervention are iterative and frequently concurrent, meaning that the process of providing support can progress back and forth between the active involvement and iterative ongoing support phases.

Developing mechanisms for effective PPA implementation

Key mechanisms identified as enabling effective implementation of the PPA programme include active engagement with parents, effective communication and participation, building and facilitating trust and providing adequate support for advocates. Mechanisms refer to relationships, thought processes and feelings associated with the role of PPAs that, if positively implemented, can help to achieve the intended outcomes and impact. Through a reflexive process, we developed ‘if–then’ statements to better understand how the intervention achieves its intended outcomes in specific contexts and to develop the final programme theory.

Mechanism 1: Building and facilitating trust

The first key mechanism contributing to the perceived efficacy of the PPA programme is the role of parent advocates in building and facilitating trust between parents and social care professionals. The initial pre-involvement phase of the PPA intervention is central to the ability of peer advocates to meaningfully engage with parents and facilitate an open conversation about the role of the social worker and child protection services. The ‘active’ phase of the intervention also plays a critical role in promoting trust and confidence in child protection services by supporting parents to overcome barriers in engaging directly with social workers and other professionals.

Research suggests that parents often experience issues with trusting professionals in CSC (Featherstone et al., 2018; Diaz, 2020). However, our findings indicate that when parents feel able to trust social care professionals and the motivations behind their involvement, they feel more willing to engage and collaborate. However, the context of child protection involvement can exacerbate the strain parents experience, making trust-building more challenging. Understanding the context within which trust-building is difficult is critical to understanding how this mechanism ‘fires’ (the point at which it activates) and when advocacy implementation is perceived as effective.

Context: Power imbalance

A key contributor to mistrust between parents and professionals is the perception of a power imbalance and parents feeling as though they are not heard or listened to. This power imbalance can arise as a result of the perceived bias of social workers and the fear of losing custody of their children. The stigma associated with child protection involvement can exacerbate these feelings of shame, isolation and reluctance to cooperate with social workers. This complex context means that many parents navigating child protection services can feel overwhelmed, powerless and alone (Gibson, 2015; Chambers, 2019).

I guess, obviously, I was nervous, because I had never had any involvement with social services… because the first thing any parent thinks is, oh my God, I could lose my children? (Parent 1)

Parents highlighted how this fear manifested in hostility towards social care professionals further impacting the ability of the parties to foster trust.

I have outright always told social services that from losing my first child I now find it very difficult whenever they come and knock on my door again, or I become very sort of like hostile. (Parent 2)

However, the role of peer advocates in enabling parents to have a deeper understanding of the role of child protection services acts to demystify negative perspectives and the fear of child removal, promoting active engagement. However, it is important to distinguish co-optation from a genuine power shift. In the longer term, without a real shift in the balance of power, the intervention could lose its positive impact. It is therefore essential for the advocates’ role in improving open communication and collaboration to create a genuine shift in power, allowing parents to have an active role in the decision-making process.

Context: Emotional difficulties and regulation

A further contributor to mistrust between parents and professionals is the imposition of unreasonably high expectations set by social workers which have potentially life-changing consequences where these expectations are not met. Parents noted feeling unable to engage with professionals where heightened emotions were at play which had a detrimental effect on their perceived ability to trust the system.

I just couldn’t understand… I’m severely dyslexic…. they bombard you with bloody letters and things. I’m dealing with this and the trauma of losing my children and my home, yeah, and along with the other mental stuff that’s going on and they just keep throwing these wild cards in to offset you, to depower you. (Parent 5)

The pressure of these expectations can also have an impact on the ability of parents to regulate their emotions when attending CPCs, making them particularly vulnerable and in need of support.

I think everyone becomes slightly vulnerable because they have a lot of these meetings and emotionally, they do need a lot of support and it’s also ensuring their voice is heard. (FGC Coordinator 1)

This highlights the importance of advocates in providing emotional support and understanding to facilitate trust-building, acknowledging the emotional toll of attending CPCs on parents and the impact of the system’s demands on their ability to engage in a meaningful way.

Mechanism operation: The advocate as credible messenger

Advocates and professionals were generally positive about the ability of advocates to engage with parents and play a meaningful role in facilitating trusting relationships between parents and professionals. Advocates and professionals noted the collaborative effort required in the trust-building process and the importance of advocates as a third party in facilitating this process.

If somebody is not trusting you… it can only be a good thing to bring somebody else on board who has more experience of this process, and who can help hopefully to build that relationship between the two sides. (Senior Manager 1)

One peer advocate emphasised the advantages of early advocacy involvement in the child protection process and how their role as mediators in helping to build relationships could support parents to prevent problems from escalating, potentially saving time and resources in the long run.

I believe an advocate could be helpful at the early stage… due to the conflict and trust issues at the outset. The benefit of having an advocate…could be more time-efficient and cost effective. (Peer Parental Advocate 4)

Parent advocates also play a crucial role in shifting perceptions of child protection services to a collaborative rather than paternalistic system (Bekaert et al., 2021). Parents commented particularly on how advocates had shifted their perceptions of the aims of the child protection system, going some way to rebuilding trust in the system.

…they’re not there just to take your children away…, that’s not their ultimate aim… their aim is to [help] children to be safe, but they’ll work with you to make sure that you can give a safe environment to the children. (Peer Parental Advocate 4)

For PPA programmes to successfully work with parents and build positive trusting relationships, however, is dependent on peer advocates’ ability to shift perceptions about the nature of child protection involvement. The mechanism is unlikely to fire where parents see advocates as simply another professional, particularly where the advocacy service is introduced by social workers, adding to their existing mistrust of the system.

There’s been a few examples recently where I’ve thought, ‘you would really benefit from having an advocate to support you’, but anything that’s being offered by the Local Authority, they’re just like “No, absolutely not, I don’t trust you. I don’t want it. There’s a hidden agenda here. (Peer Parental Advocate 6)

PPA can therefore act as a support mechanism for parents to help them to navigate a stressful system where they may not always feel understood or listened to. This ability to bridge the gap enables open communication, facilitates trust and helps parents to be more honest with social workers about issues they may be struggling with. Where this mechanism is successful, it has the potential to contribute towards safely supporting children to remain at home.

Mechanism 2: Active PPA engagement with parents

The second key mechanism for effective advocacy implementation is the role of active engagement between the parent and advocate, operating at all three stages of the intervention where it ‘fires’ effectively. During the initial pre-involvement phase of the intervention, appropriate preparation of the advocate for the cognitive and emotional dimensions and challenges of the role is critical to enable them to actively engage and collaborate with parents. This is critical to the perceived efficacy of the programme given the central role active engagement has for parents’ ability to build trust and collaborate with professionals (see mechanism 1). In turn, this improves parental engagement with social care practitioners, a factor recognised as a key component of effective social work practice (Horwitz and Marshall, 2015).

During the active involvement phase, the advocate provides emotional support and breaks down complex language and processes, which increases parents’ understanding of the child protection process, leading to more effective communication with professionals. When parents feel confident that they have someone on their side, they feel empowered to meaningfully engage in CPCs. Ongoing training and feedback for advocates during the iterative support phase are valuable for improving engagement and identifying areas where further support or ongoing training is required.

Context: Complexity of the system

Parents and professionals expressed concerns about the complexity of the child protection system and associated conferences, creating a picture of an oppressive and intimidating system due to overly complex roles, making it difficult for parents to navigate and engage effectively with professionals.

I noticed that there were many agencies involved in the family, and there was a sense of mum feeling overwhelmed and somewhat hopeless. (Peer Parental Advocate 3)

This was further compounded by the blurred remits of different agencies. One social worker acknowledged this issue, expressing concerns about overloading families with various professionals with similar remits.

It’s a bit like being in a spider’s web sometimes… Are we overloading the family with lots of different people who have a kind of similar remit, because quite a lot of the remits are quite creative so they can be a bit blurred…

In addition, the extensive range of supports can make it difficult for parents to identify the support that is available, leading to a feeling of inaccessibility and ‘information overload’ which, when combined with the complexity of child protection processes, creates a significant challenge for parents attempting to navigate this system without support. Previous literature highlights how the complexity of child protection processes represents a key barrier to effective parental engagement in CPCs (Featherstone and Fraser, 2012). In this context, parents can find the offer of an advocate confusing and perceive it to be an additional stressor where the role is not properly explained.

It is a lot of information overload and some of the information is not… properly explained sometimes, so it goes in and out… go to lots of different services to do lots of different things, and then on the top of that say ‘Oh would you like an advocate?’ ‘What’s that?’ (Peer Parental Advocate 6)

Context: Complex terminology

Furthermore, the complex language and terminology was perceived as compounding the inaccessibility of CPCs for parents, aligning with previous studies that find parents can benefit from advocate support in deciphering professional jargon, policies and procedures (Lalayants et al., 2021).

I think a very well-trained advocate with lived experience of child protection processes themselves can be very, very helpful in those contexts because a lot of the terminologies and consequences of what we’re discussing are really difficult to understand and take apart for parents. (Social Worker 1)

Social workers reported difficulties in providing simple explanations to parents highlight the overwhelming nature of the complex language and structure of child protection processes for parents, particularly those with little or no experience of the system. This creates a clear imbalance of power which can inhibit meaningful parental engagement.

…obviously I’m generalising.., but I think in that space they’re like, ‘Can you please explains the process for me?’ Because I quite often go on the [information] website myself to be like, ‘This is…’ and I’m going to try and explain it into really like simple terms, but I haven’t… I haven’t been through it as a parent. Like, I don’t know what it feels like. (Social Worker 2)

Parents particularly highlighted that PPA engagement in understanding processes and reports enabled them to engage more effectively in the process.

I feel like I am being told more information instead of just being handed a piece of paper… the reports like the child protection reports and stuff …. Normally we just get handed them. No one wants to go through them, no one wants to explain… (Parent 3)

This highlights the role of the PPA in acting as a conduit between parents and professionals, ensuring that parents are well-informed and able to participate fully in the decision-making process.

Mechanism operation: Meetings feel more accessible

Feedback from parents and advocates highlighted that where appropriate support and knowledge were given, CPCs felt more accessible to parents. Consequently, where parents felt they could speak and engage, they began to feel that their voices were being heard, reinforcing their confidence to actively participate in these conferences.

So I just feel when our work with them before the conference is incredibly important, even during the conference it is but it’s before the conference when the work is done about understanding, making them to feel confident, and actually just having their voice heard first and then, you know, that can be translated on to the CP conference. (Peer Parental Advocate 5)

In addition, having a peer advocate working solely in their interests helped parents to feel supported and that they had someone on their side. Peer advocates have a unique understanding of the emotional impact of child protection involvement as a result of lived experiences, which helped parents to feel understood and less stigmatised.

And I think for me, peer-to-peer support, the support you’re getting is that actually, you know what, I’ve been through it, I’ve lived it, I’m now in a position I can now support other people who are in this, you know, because I’ve come through the fire. (Peer Parental Advocate 2)

Improved understanding of child protection processes and procedures empowered parents to engage more actively with professionals. When parents have a good understanding of the system and processes, they are better equipped to participate more meaningfully in the decision-making process. This was perceived to rebalance power relations though this only occurred where advocates and parents worked collaboratively with professionals rather than adversarially. Finally, effective, ongoing training helped advocates to feel they could effectively work through their lived experience to support parents through the process.

Mechanism 3: Enabling effective communication and participation

A further mechanism for the effective implementation of PPA is the specific role of advocates in enabling effective communication and participation between parents and professionals during the active involvement phase of the intervention.

Context: Ensuring parents’ voices are heard

Research shows that without an advocate, parents can feel anxious around social care involvement, inhibiting communication and willingness to engage with professionals. For example, Diaz (2020) found that parents often felt anxious, many reported feeling they were treated like objects and that compliance was key in order to deter escalation of child protection intervention, leading to inhibition in sharing thoughts and feelings with social care professionals for fear of their children being removed. Bekaert et al. (2021) similarly found that many parents feel unduly pre-judged and disempowered by the child protection system and expectations set by social workers. Similarly in our evaluation, parents and advocates highlighted the oppressive nature of the child protection system and the associated fear of losing children.

Parent advocates play a crucial role in promoting effective communication in CPCs, and empower parents to feel that their voice is heard by providing knowledge and understanding of the processes. This aligns with previous literature which found that parents noted improvements in their ability to effectively communicate when supported by parent advocates (Featherstone and Fraser, 2012).

It’s not… the professional. So, they have the right to do this, and so there’s nothing to be scared of or fear of, just that I hope my role can empower them to speak up for themselves. (Peer Parental Advocate 1)

A barrier to effective communication and participation was identified as the overwhelming nature of CPCs with parents’ voices lost amidst a sea of professionals, creating a power imbalance that inhibits meaningful parental engagement in the process. Acknowledging this power imbalance was perceived by research participants as critical to the ‘firing’ of this mechanism.

Peer advocates highlighted the lack of time spent between parents and professionals, and parents feeling of being outnumbered and disempowered, leading to a lack of trust in child protection services and hindering communication. Advocates are perceived to be a crucial component in enabling the communication element of the mechanism since they often have more time to get to know the parent and their needs.

A lot of the time when you are going into conferences as a parent, there’s a lot of professionals that don’t really know you. But then we’ve taken the time as a parent advocate, I’ve taken the time to get to know that parent. (Peer Parental Advocate 4)

Mechanism operation: Parents confident to express wishes and feelings

Peer advocates’ work has led to a growing understanding that removing children from the home is often not in their best interests, and their role in enabling communication and empowering parents has helped to rebalance power relations and boost parents’ confidence in expressing themselves before, during and after CPCs, thus enabling them to voice their wishes and feelings.

And the other thing is I've found it easier to communicate to my advocate how I feel and what I want than I do to a social worker because I feel like the advocate’s on my side and for me, social services are not on my side, never will be on my side, and you will not convince me of anything other than that. (Parent 4)

In practice, this mechanism is the most effective when the advocate supports the parent themselves to speak out, or alternatively, being the voice of the parent where they lack the confidence to speak out. This is critical in breaking down barriers to participation, resulting in CPCs feeling more accessible to parents.

Our work with them before the conference is incredibly important, even during the conference it is but it's before the conference when the work is done about understanding, making them to feel confident, and actually just having their voice heard first and then, you know, that can be translated on to the CP conference. (Peer Parental Advocate 5)

The potential complexity of social workers receiving criticism and pushback from parents about areas of disagreement, however, presents a barrier to this mechanism. This rebalancing of power, coupled with the risk of adversarial consequences can lead to conflict. These comments indicate the importance of focusing on the overall ‘macro’ level of child protection interventions in order to streamline and simplify the process and make it more accessible to parents and facilitate communication.

Mechanism 4: Effectively supporting advocates to do good work

The final key mechanism for effective PPA programme implementation is appropriately and effectively supporting peer advocates to do good work. This is key throughout all stages of involvement where peer advocates receive ongoing supervision, training and support.

Context: Empowering peer advocates to do good work

Where competent, tailored and ongoing supervision is provided, advocates feel empowered to use their lived experience to support parents and pass on their knowledge and experiences. Indeed, it is their lived experience of the child welfare system and the associated stigma, isolation and range of emotions that enable their unique ability to understand the process from the perspective of the parent and work with them to promote engagement and positive outcomes (Lalayants, 2013; Lalayants et al., 2016). However, the nature of this involvement means that effective support is a key mechanism underpinning this.

If you're a parent advocate supporting the family in a child protection space and you have experience of the child protection system you will need a particular type of support and supervision, if you've had experience of, you know, having a baby or having an early help family worker it will be a different type of supervision again, you know different levels of intensity and nuance. (Service Manager 1)

The need for effective and comprehensive training was a key consideration by peer advocates in this study. In particular, it was noted that whilst general support and training exists for advocates, specific more tailored support would be useful in certain aspects of advocacy.

I think the support you need is based on the clients that the Local Authority has. Like, [LA] has a lot of, like mental health, and, like, domestic violence: very specific type of dramas they deal with, you know? So having that kind of familiarity … would allow you to better support that family. (Peer Parental Advocate 1)

Interviews also highlighted the need for tailored emotional support for peer advocates given the complexity and often challenging nature of the role. Peer advocates felt it was important to feel they had someone to speak to where they encountered difficulties.

We have more peer supervisions, more chats. I have a nominated person that I can talk to if I need to, things like that… and that’s very important. (Peer Parental Advocate 1)

In addition, managers were highly reflective of the level of personal support provided to advocates throughout engagement in the programme.

I think my duty of care to people is sort of checking in with them afterwards and sending them a little WhatsApp and saying thanks very much for your contribution, you okay, and just checking in, checking in and being available… (Service Manager 3)

This echoes previous research that identifies ongoing supervision as a key requirement for effective PPA implementation, with peers who received regular and supportive supervision being more likely to stay in advocacy roles for a longer period of time (Riley, 2010). Similarly, advocates in this case indicated that regular supervision both individually and as a group were useful when actively supporting parents.

We have supervision every four weeks individually and as a group as well… so that kind of helps to share experiences and stuff like that. (Peer Parental Advocate 3)

Effective supervision and ongoing support for peer advocates are critical to ensure their consistent engagement in advocacy roles without burning out, which suggests the need for flexible and adaptable supervision to meet the specific needs of parent advocates.

Despite the recognition of the value of effective supervision practices, some professionals expressed concerns about the risk of advocates overstepping boundaries and managing personal trauma. Research suggests that peer advocates may be especially vulnerable to unresolved personal challenges that impact their role (Huebner et al., 2018). Similarly, this was seen as a potential conflict associated with peer advocacy and involving individuals with lived experience in this programme.

So, the advocacy work may well surface difficult emotions, feelings for them, some of which may not be fully resolved. this could be a challenge for people. (Service Manager 2)

Despite these reservations, peer advocates demonstrated a clear understanding of the boundaries of their role and vigilance in establishing and maintaining them. By remaining neutral, advocates can provide valuable support and information to parents, enabling them to make their own decisions.

I need to be aware of the boundary, which I think is crucial…I am providing the information and support for them but not trying to sort out their problem. I can voice for them but not make the decision for them…I should always remain neutral. (Peer Parental Advocate 6)

Advocates also noted some potential challenges in setting and maintaining boundaries, though an awareness of these difficulties demonstrates where effective training and support can positively support peer advocates.

I find it difficult about boundaries. You need to have your boundaries, and you have to be very strict boundaries in terms of what you do, how much you help… it’s quite difficult to explain sometimes to families, because they feel or they believe that well, you’re helping them, you know what I mean? (Peer Parental Advocate 5)

These comments suggest that providing adequate supervision is a critical factor in ensuring quality advocacy, effective parental engagement and positive outcomes and emphasise the importance of training and ongoing support for individuals who use their lived experience to support others.

Strengths and limitations

This study represents the most extensive evaluation of PPA services in England and Wales to date, gathering detailed and rich data. However, the study is limited to two LAs, which were similar in demographics, socio-economic factors and service provision, which restricts comparisons with other advocacy services. Recruitment was limited due to the small and new nature of the programmes in each LA, with a relatively small sample size, which may limit the generalizability of the findings. Nevertheless, the study provides valuable insights into the perceived impact of PPA services and identifies key underlying mechanisms.

Conclusions

This research builds on early evidence that suggests that peer advocates can bridge the gap between parents and social workers, facilitating positive working relationships (Diaz et al., 2023). This article identifies four key mechanisms that contribute to the effective implementation of a PPA programme: engagement, communication, trust and support. The peer advocacy role is perceived as critical in helping parents understand complex processes, terminology and expectations, leading to increased parental engagement and collaboration with professionals. Advocates also facilitate meaningful communication and collaboration, a key mechanism by which parents feel empowered to play a meaningful role in decision making. The trust mechanism activates where advocates address stigma and negative perceptions of child protection involvement, improving relationships and increasing the likelihood that parents feel safe to be open and honest with social workers about their needs to receive appropriate support. Finally, effective training and support for advocates is essential for ensuring they are competent and feel valued, which promotes engagement and consistency in their role.

Since the project began, the IRCSC in England (2021) recommended a national rollout of parental representation in child protection services, noting transformative examples of parent advocacy that have kept children safe with their families (MacAlister, 2022, p. 86). This indicates a likely increase in the use of parent advocacy services in England. This pilot study therefore provides early evidence of mechanisms that underpin successful PPA implementation and the circumstances that enable them to work effectively.

Directions for future research

Whilst this study highlights two successful contexts for PPA programme implementation, it is important to recognise that child protection processes may differ across other LAs. This study supports the recommendations in the IRCSC (MacAlister, 2022) and provides a valuable starting point for further exploration of PPA programmes, However, future research should examine the PPA service implementation in different contexts and investigate whether PPA interventions shift the balance of power, or simply create the perception of a shift, both of which have implications for policy and practice. Additionally, the impact of PPA services should be compared across a wider range of LAs, and measure long-term outcomes such as improvements in child protection and reduced child removal rates.

Acknowledgements

The authors thank the LAs involved for taking part in this study and all the parents and professionals who were interviewed and took part in the focus groups.

Funding

The findings in this paper are based on research funded by What Works for Children's Social Care.

Conflict of interest statement. CASCADE Partnership receives infrastructure funding from Welsh Government, through Health and Care Research Wales.

References