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The behaviour of children involved in theft, violence and drug abuse can improve dramatically if they are closely supervised and become involved in a detailed programme of education, according to residential care worker Pete McFadden. However, significant problems can arise if such children claim that they have been sexually abused while in local authority care. This is partly because their previous behaviour makes them not very credible as a witness. Such children can often feel very unsafe, and it is therefore important for them to be encouraged to trust one or two adults.

The safety of children must ultimately come before the needs of their mother, according to senior social worker Joanna Davis. She had to address this issue when working with a young mother who showed little interest in bringing up her three children.

It is vital to challenge conventional responses to people's care requirements, according to social worker Carol Needham, who was able to find suitable accommodation for a young man with brain injuries as a result of a suicide attempt. She emphasizes that his new living arrangement has boosted his sense of self-identity.

An inclusive and honest approach was vital when dealing with a deaf young woman with learning difficulties who was pregnant by a schedule one offender who abused alcohol, according to social worker Ros Kennedy. She indicates that she focused on ways of empowering the young woman.

Forensic social worker Marian Trendell's experiences of treating a seriously disturbed young man who was a danger to himself and others are presented. Trendell feels that although he has made progress he still needs to be in a secure unit.

Taking a client with Alzheimer's disease out of familiar surroundings can have negative repercussions, according to social worker Sue Binns. She emphasizes that social workers have no powers to force Alzheimer's disease victims to enter residential care.

Dealing with a case of extreme domestic violence presents significant challenges, according to Mandy Roberts, a social work care manager in a physical disability and sensory impairment team for adults in Denbighshire, England. When dealing with a case in which a husband had kept his wife locked up in their flat for 10 years, had been physically violent towards her and had neglected her health, Roberts had to work with the police to ensure that the husband could not remove his wife from the residential home in which she was placed when he went into hospital for an operation. She emphasizes that she had to keep her own feelings of anger under control in order to support the wife in the best possible way.

Early multi-agency intervention is vital if young people who have suffered sexual abuse are to be helped, according to Wendy Shepherd, a senior practitioner in Barnardo's Bridgeway project in Middlesbrough, England. She acknowledges that she encountered a range of challenges when seeking to help a young mother who had been sexually abused as a child and had been involved in drug-taking and prostitution. She feels that this mother's commitment to her child played a key role in greatly improving her circumstances and ensuring that her child did not have to be adopted.

Visiting an extremely psychologically disturbed client at night was a risky decision, according to David Glover-Wright, a social worker in the out-of-hours emergency social work team in Milton Keynes, England. However, he felt that the risk was acceptable because he had already established a relationship with the client and had used recommended safety protocols. He believes that the episode played a role in moving their relationship onwards. He welcomes the fact that he was able to avoid a full Mental Health Act assessment.

There can be significant challenges associated with protecting a disabled child who is in the care of a vulnerable mother who lacks appropriate parenting skills, according to social worker Jo Siney. She feels that a child with disabilities should benefit from a caring family environment, but also recognizes that disabled children must have their additional care needs met if their well-being is to be secured. She believes that it was right to remove a nine-year-old boy with cerebral palsy, learning difficulties and epilepsy from the care of his mother.

It is important to be realistic about the prospects for reducing the potential risk posed by somebody with learning difficulties who has committed sex offences, according to Rona Fraser, a senior social worker in a criminal justice team in Edinburgh, Scotland. She found dealing with a case of this kind quite difficult, and she was distressed after some of the sessions with this client. However, she believes that co-working has been extremely valuable.

There are complicated legal issues associated with finding an adoptive family for a child from Eastern Europe, according to independent social work consultant Pamela Dowling. She had to address these issues when approached by a couple who had been caring for a girl from Eastern Europe and had found a family willing to adopt her. She found that the lawyer used by the couple did not seem to wish her to become involved. She has encouraged the couple and the prospective adoptive family to seek advice from social services, but little progress has been made so far.

Social workers responsible for assisting a mother with learning and emotional difficulties must make the child their priority, according to social worker Debbie Blows. They must make regular visits to support the mother in caring for her child and to assess her progress. It is important to be aware that in cases where clients receive a range of services, the care of the child will in practice be shared. This can make it harder for the mother to develop and assume full parenting responsibilities.

It can be very difficult to assist an elderly client who wishes to remain at home but refuses appliances regarded by social workers as vital to their well-being and that of carers, according to social worker Kate Martin. She encountered this problem with a client, and had to point out that she would be obliged to withdraw the home care service. She has attempted to keep channels of communication open, but feels that the client regards the social services department very negatively. She is concerned that her client is at risk of long-term health problems.

Social worker Pat Winder admits that she is finding it extremely difficult to balance the wishes of one of her clients to stay in his own home with her duty to protect him from serious risk. Winder explains that her client, an man in his 80s who has severe hearing problems and is registered blind, is clearly unhappy living in a residential home. However he has no family and sometimes appears to be confused or dementing. Winder admits that she is concerned about the involvement of one of her client's friends, particularly since her client does not want the friend to manage his financial affairs.

Manchester, England, social services department deputy director Ged Taylor is pleased that the Government is finally looking at the problem of funding the long-term care of elderly people, but is unimpressed by all three of the Government's proposals. Frank Dracup, a care manager with North Yorkshire social services department, has particularly serious doubts about the idea of using occupational or personal pension schemes to help pay for long-term care. Dave Punshon, a chief officer with Age Concern, fears that this proposal could lead to a rise in the cost of pensions.

Haringey, London, England, social worker Sylvia Henry points out that the power she has over people's lives can sometimes be difficult to deal with. Henry became aware of this power when she became involved in monitoring and supervising a baby on the protection register. Henry was forced to seek an emergency protection order when the baby was put at risk by her parents' drinking, and subsequently a care order when the parents absconded. Henry feels that she is back to square one, her role having reverted to monitoring and supervision when the parents managed to have the care order revoked.