INTRODUCTION

In the United Kingdom, parenting programmes underpinned by social learning theory (Bandura, 1977; Gavazzi, 2011) are recommended as a key intervention for young people presenting with aggression and violence (NICE, 2017). These programmes hold that the young person's behaviour can be modified through reinforcement and modelling. However, the evidence base is mixed, with a recent meta-analysis finding that no one approach is consistently superior (Bakker et al., 2017). Furthermore, the complex needs of families using services as well as the potential impasse of young people refusing to engage, means that practitioners may require alternative interventions (Coogan, 2014; Jakob, 2018b; Newman et al., 2014).

One systemic alternative is non-violent resistance (NVR) (Omer, 2004). Drawing on the sociopolitical protest movements of the twentieth century, NVR positions itself in contrast to mainstream models by suggesting that to try to change the behaviour of the young person is an erroneous endeavour (Lebowitz et al., 2014; Weinblatt & Omer, 2008). Instead, NVR aims to reassert the presence and agency of the caregiver in relationship to the young person so that they can peacefully resist the violence (Jakob, 2018b; Omer, 2004; Weinblatt & Omer, 2008). Primarily this resistance enables the caregiver to change their interactional patterns with the young person, including better managing responses to violence. However, in line with the systemic principal of circularity (Becker et al., 2022; Dallos & Draper, 2010; Selvini et al., 1980), by experiencing a more present, boundaried and loving caregiver, the young person's behaviour may also change (Jakob, 2018b; Lebowitz et al., 2014; Weinblatt & Omer, 2008).

NVR is comprised of ‘positive action methods’ including the ‘announcement’, in which the family formally announce to the young person that they will no longer accept their violence; the ‘sit-in’, where caregivers sit peacefully in the young person's room in protest to their actions; and the ‘campaign of concern’, in which the wider network around the young person makes coordinated contact to express concern or pride regarding specific behaviours (Omer, 2004; Partnership Projects, 2013). Thus, NVR positions violence in its social context (Omer & Lebowitz, 2016) and invites caregivers to draw on wider support to acknowledge the violence and bear witness to changes made within the family (Omer, 2004). Other key processes include resistance to controlling behaviour through refusal of unreasonable demands; ‘deferred responsiveness’, by which the caregiver addresses their own escalatory patterns and delays their response to aggression; and ‘reconciliation gestures’, small acts of unconditional care such as leaving a hot drink or bringing a young person their favourite snack (Omer, 2004; Partnership Projects, 2013).

Randomised clinical trials (RCTs) with families of young people with behavioural difficulties (Lavi-Levavi, 2010; Ollefs et al., 2009; Weinblatt & Omer, 2008), with anxiety (Lebowitz et al., 2019) and with foster parents (Van Holen et al., 2018) as well as accounts of work with obsessive–compulsive disorder (OCD; Lebowitz, 2013), threats of suicide (Omer & Dolberger, 2015) and multi-stressed families (Jakob, 2018b) and in residential services (Van Gink et al., 2017, 2020) all point to the potential for NVR to positively impact upon caregiver agency and the behaviour of young people in various contexts (see Omer & Lebowitz, 2016, for full review).

NVR appears to have high rates of acceptability (Weinblatt & Omer, 2008), with straightforward processes (Coogan, 2014) and with parents and professionals alike feeling more positive about their caring role (Golan et al., 2018; Newman et al., 2014; Van Gink et al., 2018). These findings are qualified by structural challenges such as organisational change (Van Gink et al., 2020) and engaging a supporters' network (Attwood et al., 2019), alongside mixed professional responses (Van Gink et al., 2018), ongoing parental distress (Weinblatt & Omer, 2008) and a lack of confidence in some processes (Van Gink et al., 2017). Therefore, whilst the clinical utility is clear, more is needed in terms of understanding the experience of working with NVR to aid dissemination and application.

This study aimed to address this by investigating the experiences and recommendations of staff using NVR in one residential care home for young people presenting with high-risk behaviours including aggression and violence. Here, NVR was introduced alongside attachment and trauma-based training for staff via whole team training, individual staff qualification, consultancy and regular supervision. Local authority and, where possible, parental consent were provided.

METHOD

The study was designed alongside a third sector organisation that runs a residential unit for young people presenting with high-risk behaviours and that had integrated NVR into all aspects of service delivery. Eight participants were recruited via email and on-site advertising. Participants were self-selecting, thereby protecting their anonymity and promoting uncensored feedback. They represented a range of experience, positions and pay-grades. To protect anonymity, it is not possible to report on further participant characteristics. All participants were offered a £10 voucher in recognition of their time.

The study was qualitative with the aim of gaining rich in-depth data and took a critical realist perspective, holding that evidence could be generalised from the participant accounts whilst acknowledging the mediating role of the sociocultural context in which it was constructed (Willig, 2013). The semi-structured interview schedule was designed collaboratively with the organisation and aimed to gather data related to staff understanding of the principles of NVR, the impact of working with this approach and the role of the organisation, with particular focus on staff recommendations for improvement. Each interview lasted approximately 60 min and was conducted, audio recorded and transcribed verbatim by the primary author.

The data was analysed using thematic analysis (Braun & Clarke, 2006), which is well suited to the epistemological stance of critical realism. In line with Braun and Clarke (2006), the primary author first immersed themselves in the data, before identifying extracts relevant to the research questions and drawing together initial codes. These codes were grouped into potential themes, which were cross-referenced with the original data. Axial coding (mind mapping) (Willig, 2013) was used to organise and refine the themes, bearing in mind their saliency across the data set and to the research questions. Final themes were identified for the purposes of this paper, with further refinements occurring during the writing process.

Since thematic analysis is inevitably a process of construction, secondary coding is not considered to necessarily add to research validity (Terry et al., 2017). Instead, the primary author participated in supervisions with the second and third authors and used a reflective diary to consider the experiences that may have impacted.

RESULTS

Data analysis led to four main themes: NVR is both a set of processes and a way of being, NVR and transformation, NVR and the personal–professional divide, NVR and organisational support, each with a number of sub-themes and recommendations for service improvement.

NVR is both a set of processes and a way of being

Participants described NVR as both a set of processes and a way of being in the world.

Set of processes

Participants noted that NVR provided a clear set of processes, a concrete plan of action in the face of challenging work. Some suggested that it was helpful that many of these processes, such as the ‘announcement’, were formulaic, even scripted, and so could be easily followed and put into practice.

It's so simple and it's formulaic […] it's an easy formula to follow. (P6).

The supporters' networks got so tokenistic and it was just basically the staff in the homes spamming all the other staff to send messages about young people that they barely knew. (P2).

However, three of the participants expressed concern that the availability of set formulas could lead to ‘robotic’ (P3), ‘lazy’ (P2) or disingenuous interventions, for example, mobilising a ‘supporters network’ becoming ‘spamming’ anyone on shift (P2). It was agreed that, for NVR to be effective, the practitioners needed to be creative with the processes and also understand and invest in the meaning behind them since the young people could easily recognise when this was lacking.

Participants recommended prompts to remind staff of the meaning behind interventions. Another suggestion was for staff to practice translating NVR templates into their own language to reduce tokenistic replication. Finally, one participant suggested that interventions should not be regularly repeated if they do not generate change in the young person.

Way of being

Alongside a concrete methodology, NVR was also described as an overarching way of being in the world.

I do not think you do NVR, I think you be NVR. (P7).

I see the NVR approach more of a philosophy, of a way of living than a model. (P6).

NVR was a ‘philosophy’ (P6), a ‘mentality’ (P1) and an embodied practice. Particularly striking was the repeated description of NVR as a way of demonstrating love for the young people. As such, NVR was understood as an ethical as well as functional practice.

NVR and transformation

Participants described ways in which NVR had transformed the organisation, the professional role and the experience of the young people in their care.

NVR is different

The participants positioned NVR as an entirely different way of working compared with mainstream models of care, meaning that staff had to ‘unlearn’ (P4) previous experience.

It's just something so different to what you have ever done. (P5).

Organisational transformation

NVR marked a distinct shift in the organisation.

It's completely transformed (P2).

We started realising that it was gonna completely revolutionise how we look after the children. (P6).

Participants described the organisation as previously ‘entrenched’ in practices which normalised violence and used a consequential model to try and control the young peoples' behaviour.

We were very much consequence based led […] ‘They smashed it up, how much shall we charging [sic] them’ and then […] we would often feel so powerless […] they really did not care about their pocket money (P1).

This practice was now seen as ‘punitive’ and ineffective, with NVR offering a systemic alternative in which seeking to change the young person was no longer the imperative.

NVR had fundamentally changed the role of the organisation from a residential unit to a family home. In line with an embodied practice, participants noted the way in which NVR had transformed the language of the organisation in a shift towards a less institutional vocabulary, a shift which was apparent across interviews, with ‘team’ described as ‘family, ‘colleagues' as ‘friends' and ‘staff’ as ‘parents'. Participants also related NVR to greater team cohesion.

When you are doing a campaign […] you are all in it together and it reminds you you are actually a team. (P3).

Professional transformation

Participants consistently stated that NVR had transformed their professional role for the better. Both the processes and the philosophy were seen to have enabled staff to better manage an extremely challenging role. Two participants in particular noted that, by moving the focus away from the young peoples' behaviour, NVR provided clearer therapeutic boundaries so that they knew that they were ‘doing enough’ (P3).

We're sitting there with our kids and going ‘we have done everything, we are burnt out, we have nothing left’ […] NVR gave us something structurally when talking about those people to continue to use so […] you can do what you do then you leave work and you go ‘I've done my bit for that kid today’. (P4).

One participant wondered whether this might lead to a decrease in professional burnout, and another felt that NVR had improved staff retention.

Participants noted that NVR had led to an increase in their professional autonomy, with a new impetus on them to initiate pieces of work.

NVR helped me just go ‘no, I need to do something’ and be proactive […] whereas before I would have waited to be asked to. (P3).

Whilst some positioned this autonomy as welcome, a consistent theme was the confidence NVR demands. Participants explained how challenging it was not to respond to abuse in the moment, and NVR was described as seeming ‘complicated’ (P8) and ‘scary’ (P5), at odds with descriptions of its simple, formulaic processes. Limited opportunities to practice the larger interventions, fear of experimentation and personal anxieties were all cited as barriers.

People are scared of going away from the mould and then not being able to call it NVR. (P3).

Ongoing practice, including role-plays, and further imbedding NVR within daily discussions across the organisation were both sited as opportunities to develop confidence.

Finally, participants described NVR as time intensive, with increased workloads and difficulty integrating interventions into the day-to-day running of a home.

I've gotta wash up, I gotta take the kids [sic] school, I've gotta go and do the shopping […] It's really hard to kind of juggle it all. (P7).

Whilst participants acknowledged the reality of organisational pressures, protected time to plan NVR interventions, increased staffing and a full-time NVR consultant were all suggested as ways to address this challenge.

Transformation for young people

Whilst the majority of participants noted that NVR did not focus on changing the young person, change in them nonetheless appeared to be significant.

Every single intervention I have ever done has created movement. (P2).

It's amazing actually the difference. (P5).

Participants described how NVR had improved their relationships with the young people, led to a reduction in violence, an increase in therapy uptake and fewer placement disruptions. Significantly, this transformation could take time, which some participants acknowledged could be extremely challenging, a challenge compounded for one participant whenever placements were terminated prematurely.

In contrast to descriptions of transformation, participants also expressed concern that NVR could feel inactive. For some, this meant talking about NVR more than doing it and one participant described NVR as ‘doing nothing’ (P8) when the young person's behaviour did not change, a frustration which they believed others shared.

Where the kids are smashing up the house and it's constantly being smashed and we are doing nothing about it but actually we are trained to restrain and we are not doing it. Why are we not doing it? (P8).

The solution for this participant was recourse to potentially more restrictive methods such as restraint or involving the police. The latter was raised by two other participants as a dilemma when practising NVR.

Working with wider systems

The transformation of organisation and staff was seen to have had significant implications for working with the wider systems around the young person.

Many participants focused on work with families. For some, NVR had improved this by centering the family's role through ‘announcements’ or ‘supporters networks’. However, participants also described difficulties with reluctance, explaining NVR and managing the needs of both young people and their families alongside limited time and resources.

It's like pulling teeth sometimes and it's like ‘Oh God we're gonna have a session with them and they're gonna be really resistant, we're gonna have to say these same things over’. (P6).

Some participants also described the way in which working with NVR separated the organisation from other statutory services who continued to endorse behavioural models of care. This had led to the organisation feeling like a ‘lone voice’ (P4) and to conflict as to how to best support young people.

Local authorities are still in the old tradition of working […] most of them […] that kind of punishment–reward thing. (P6).

Developing the understanding of families and key statutory organisations, including schools, the police and local authorities, through NVR training was identified as a way to improve collaborative work with wider systems.

NVR and the personal–professional divide

A repeated theme running throughout all interviews was the way in which NVR challenged the divide between the participants' personal and professional worlds.

At the start it was like this is just something I do at work and then before you know it it's your life. (P1).

Use of the self

NVR was seen to harness each individual's personality in the therapeutic endeavour. Emotional investment was positioned as key, and NVR was seen not simply to demonstrate but to generate love and care.

NVR […] connects you to the young person a lot more […] because you are more present in that young person's life rather than just being there on shift, you are quite present with their family, with their friends, with everything that they do. (P1).

Conversely three of the participants noted that at times ‘reconciliation gestures’ could be forgotten.

Personal change

Just as NVR was seen to have transformed the organisation, it had transformed the participants, with many explaining that they felt calmer. All described using NVR outside of work and most gave examples of where they had found it helpful with friends and family.

I do not argue with my mum as much and I'm much better at reconciliation and overcoming that old sense of justice of ‘I'm going to withdraw my love now to punish you for whatever argument we have had' […] so I'd say my relationships are better. (P6).

NVR's allowed me to […] take some control back [sic] my own life. (P8).

Personal and professional boundaries

Whilst the role of NVR in participants' own lives was seen as positive, the dismantling of traditional work–home boundaries did pose some complexities and contrasted with accounts of NVR providing clear therapeutic limits. In particular, participants described the way in which staff were asked to contribute to NVR interventions during their time off, for example, via a ‘campaign’ message or ‘sit in’. Whilst one participant spoke positively about this in terms of feeling able to ‘support your team’ (P1), two others expressed concern about NVR becoming ‘all consuming’ (P4).

I do not wanna lose myself in this. When do I stop doing NVR and feel okay? (P4).

Participants appeared to find it difficult to think of solutions to this dilemma, noting the way in which the use of the whole self was part of what enabled NVR to function.

It's a community thing; you either buy into it or you do not so how do you half buy into it? (P4).

NVR and organisational support

Participants identified a number of ways in which the organisation had impacted their experience of NVR through training, managerial and team support.

Training

All but one participant described strong, initial reluctance to using NVR. NVR seemed ‘alien’ (P1), ‘all wrong’ (P2) and a ‘hippy peace thing’ (P4) with the ‘reconciliation gestures’ seeming particularly problematic.

I could not get my head around that [reconciliation gestures]. I was like ‘why am I then being nice to somebody that's just hit me?’ (P3).

Despite early concerns, the participants were extremely positive about the training, with role-plays and stories seen as particularly helpful. However, the training could be ‘academic’, with two participants explaining that the written element of advanced training had been a challenge.

We had to do this dissertation and stories […] that was nerve wracking for me. (P5).

Alongside training, participants described how seeing NVR in action and putting it into practice had been important in their understanding.

You have to work NVR in order to really gain as much as possible from the training. (P6).

Participants consistently recommended further training and opportunities to practice skills. Questions were also raised about the potential for visual alternatives to written training materials and more diverse assessment methods to address the risk of academic elements becoming a barrier.

Management

Managerial support including high levels of supervision were framed as key to effective implementation of NVR. For two participants, NVR explicitly directed management attention towards staff needs.

It focuses the management more on empowering the staff. (P6).

The demands of the job meant that some participants could forget or feel unable to ask for support. A significant theme was the need for management to recognise when staff were struggling and at those times be more proactive in suggesting NVR interventions.

Team

Team collaboration was seen as crucial in effective use of NVR. For one participant, positive relationships ensured that the team could function well as a ‘supporters network’ and team members could also ‘remind each other’ about NVR.

We are all quite supportive and we remind each other about NVR. I've been in the car with a colleague and the kid was in the back like really not being very good and I remember […] we looked at each other and we were like ‘NVR’. (P7).

For another, their team helped them to contain the strong feelings provoked by abusive interactions with young people rather than escalating in the moment.

That's what your teammates are there for […] ‘Oh my god, can't believe they've just said this to me.’ (P8).

However, some participants reported that not all staff are invested in NVR, with the risk of individuals feeling ‘unsupported’ or with it being the same few participating in interventions in their own time. For one participant, the experience of NVR as a ‘way of being’ compounded this challenge.

You cannot really expect some people to just kind of be NVR if they are not willing to. (P1)

Participants suggested that improvements to pay and working hours might help address this split.

DISCUSSION

The aim of this study was to contribute to the growing evidence base for NVR and, in particular, investigate professional experiences of NVR in the care sector, with a mind to improving its use and providing guidance for other services. The participants described NVR as both a set of processes and a way of being in the world, thus clearly reproducing the sociopolitical fundaments as both directed acts of resistance and embodied, loving practice (Omer & Lebowitz, 2016). A novel finding is the risk of NVR's seemingly formulaic simplicity leading to unthinking replication, which was seen to undermine the principles and, so, efficacy of the approach. How might services then support staff who are able to attempt the practices (the doing) of NVR but less so the principles (the being)?

Concern was raised regarding the repetition of interventions where there is no apparent change in the young person's behaviour. This is at odds with the premise that NVR is not contingent upon the young person (Weinblatt & Omer, 2008), and further that it is through persistent repetition that change may occur (Omer, 2004). The finding points to the potential challenge for caregivers of looking beyond immediate change in the young person for measures of success and increased supervision and support when repeating interventions may be of benefit.

NVR was described as transformative for the organisation, the staff and the young people. It was seen to have clear clinical utility and was positioned as a welcome alternative to behavioural models of care, thus replicating findings elsewhere (Newman et al., 2014; Omer & Lebowitz, 2016; Weinblatt & Omer, 2008). Reports of increased team cohesion also add to the evidence that NVR can improve the workplace environment in the care sector (Van Gink et al., 2017, 2018).

Staff, like parents (Attwood et al., 2019), reported increased autonomy. However, this was problematised by issues of confidence, particularly when planning larger interventions – again, a concern found elsewhere (Van Gink et al., 2018). As such, organisations may need to consider more focused training and support with ‘positive action methods’ such as the ‘sit in’ and ‘announcement’.

An interesting finding is the concern that, despite providing concrete plans for action, at other times NVR can feel like ‘doing nothing’. NVR encourages deferred responsiveness (Omer, 2004), by which response to violence is not immediate and involves presence-raising systemic strategies such as a ‘sit in’ or ‘campaign of concern’ rather than punitive, or aversive, interventions to act as a deterrent, as in a behavioural approach. The finding points to the potential challenge for caregivers of not acting in the moment, and the recourse to restraint requires careful thought, perhaps exemplifying Van Gink et al.'s (2017) finding that, during challenging periods, professionals are more likely to revert to historic practices.

The challenge of engaging with the wider system is a repeated difficulty (Attwood et al., 2019; Hicks et al., 2019; Jakob, 2018b; Omer et al., 2013). Participants echoed recommendations made elsewhere that all organisations around the young person should be trained in NVR (Van Gink et al., 2017, 2020), which speaks to the tensions of transforming practice in the context of underfunded and fractured services.

The participants' accounts of personal–professional dilemma add a number of novel findings to the literature, including the use of individual personalities in the therapeutic endeavour and the importance of emotional investment. The capacity of NVR to generate loving feelings replicates the experience of parents (Newman et al., 2014) and reflects the child-focused NVR practices introduced in the organisation (Jakob, 2018a). Given this finding, it is perhaps surprising that the ‘reconciliation gestures’, a key process by which caregivers demonstrate their unconditional love (Jakob, 2018a; Omer, 2004), were forgotten by some. Since parents have reported finding ‘reconciliation gestures’ particularly helpful (Hicks et al., 2019), this ‘forgetting’ may point to the complexity of translating NVR into the workplace, where parenthood is consciously constructed and necessarily framed by conditions of employment. Further consideration may therefore need to be given to the meaning of ‘reconciliation gestures’ for professionals and how these are integrated into their NVR practice.

The participants described multiple ways in which NVR had impacted on their sense of self and their personal relationships. Particularly significant was the finding that NVR challenged the traditional boundary between work and home (the shift to familial language within the organisation exemplar here), posing ethical questions about professional expectations. This appeared as an ongoing tension without a clear solution, given the fundamental premise of NVR as a ‘way of being’.

Overall, the findings here suggest that NVR creates a liminal role between professional and parent, and it is interesting that a similar experience of shifting boundaries has been reported by supporters (Hicks et al., 2019). This third space, which challenges normative ideas of best practice, invites further investigation to understand the therapeutic function and personal implications for practitioners and young people alike.

Participants described a range of ways in which the organisation had impacted their experience of NVR. The reports of initial reticence in training are consistent with experiences elsewhere (Van Gink et al., 2020), suggesting that early scepticism may be an expected part of the arc of learning, perhaps because of the contrast with mainstream models. Whilst participants spoke enthusiastically about their training, a significant concern was the potential for academic components to disadvantage or turn some away, and organisations may need to consider how to support those with additional needs to pursue advanced training.

Participants consistently noted the support of their management. However, just as parents can find it difficult to seek support in the face of abuse (Coogan, 2014), participants explained that they require more proactive input during challenging periods. An interesting finding is NVR seeming to focus management on staff needs, and further research into how NVR impacts upon leadership is of interest.

Finally, a significant finding was the reported split within the team in regard to the use of NVR. It is important to consider the impact of simultaneously working with resistance from young people, from the wider systems and also from teammates. Goodwill and enthusiasm may not be enough (Van Gink et al., 2020), and organisations may need to consider significant, ongoing investment in teams to manage these challenges.

Limitations

The small sample size limits the generalisability of the findings. Although it has not been possible to report on participant characteristics, it is important to note that these were limited in terms of age, ethnicity and gender. Whilst the experiences reported were consistently positive both in terms of NVR and the organisation, more critical experiences were alluded to, and capturing these may complexify and balance the findings. The fact that this was an opt-in study, with participants requested to take part in their own time, is likely at play here. Finally, data analysis was conducted by one researcher, and firm conclusions should be tempered by appreciation for the personal and sociopolitical context in which they were constructed.

CONCLUSIONS

This is, to the authors' knowledge, the first investigation in the English language into the adaptation of NVR and its practice within a residential child care setting. The aim of this study was to contribute to the growing evidence base for NVR (Willig, 2019) and, in particular, investigate professional experiences of NVR in the care sector with a mind to providing guidance for other services. Findings indicate that NVR is experienced as both an effective and acceptable practice, providing a clear alternative to behavioural models of intervention with young people presenting with high-risk behaviours. NVR is experienced as both a clear set of processes and a way of being in the world. It was seen to have transformed the participating organisation, the professional role and the experience of the young people and to have challenged the traditional boundaries of the personal and professional, creating a third space which warrants further investigation. Consistent investment in staff, including training, managerial and team support, was seen as central to working in this way, with ongoing tension as to managing reluctance both within and outside of the organisation.