Counselling teenage girls on problems related to the ‘protection of family honour’ from the perspective of school nurses and counsellors

Abstract

Approximately 1,500 young immigrant women living in Sweden sought help from various public organisations during 2004 due to problems related to Protection of Family Honour (PFH). Often they seek help from school nurses and counsellors. Information on how the school nurses and counsellors manage this complex PFH phenomenon is limited in Sweden. The aim was to generate a theoretical model that illuminates the experiences of school counsellors and school nurses counselling teenage girls, who worry about problems related to protection of family honour. Data were collected through individual interviews of the school welfare staff. The study subjects included welfare staff from six upper-secondary schools consisting of four nurses and six counsellors. Grounded theory methods were used to generate new knowledge as this is a new field of research. The staff's main goal was to provide the best support and help for the teenage girls. In addition, they wanted to be true to their professional ethics and values. However, this was difficult and created professional dilemmas because some teenage girls prevented them from doing what they thought was needed to support the teenage girls and protect them from violence. As a result, staff sometimes felt hampered, unable to help or able to help only in ways hidden from the teenage girls' families.

The role of the school nurse in protecting children and young people from maltreatment: An integrative review of the literature

“…A proactive approach to supporting children and families with child maltreatment issues involved school nurses and colleagues seeking to empower children and young people and be an advocate for them (Alizadeh et al 2011;Eisbach and Driessnack 2010;Engh Kraft et al 2016). In five studies school nurses supported families to access other agencies and make appointments for their children, and sometimes acted as a lead for child maltreatment cases (Chase et al 2010;Engh Kraft and Eriksson 2015;Jordan et al 2016;Joyner 2012;Schols et al 2013).…”

“…A second study focusing specifically on the identification of emotional abuse identified school nurses were most likely to hypothetically refer case vignettes to other agencies when they involved criminal activity, sexual exploitation and physical punishment (Pakieser et al 1998). When school nurses and their colleagues in two studies felt less sure about cases of maltreatment, they would seek to gather further information to understand the situation better (Alizadeh et al 2011;Eisbach and Driessnack 2010). This was achieved by monitoring and questioning the family, arranging additional visits, talking to teachers, counsellors and school friends, and organising a one-to-one appointment with the child (Eisbach and Driessnack 2010;Jordan et al 2016, Paavilainen et al 2000, Paavilainen et al 2003, Schols et al 2013 Kraft et al 2016;Hackett 2013;Sekhara et al 2017).…”

“…School nurses in one study could be hesitant to report suspicions of child maltreatment to social services because they worried it would leave the child in a state of uncertainty (Engh Kraft and Eriksson, 2015). In two studies, these reporting decisions were influenced by previous negative experiences with referral to social services (Alizadeh et al 2011;Engh Kraft et al 2016). In four studies, nurses felt that the social care system was overburdened, and they would receive inadequate feedback (Eisbach and Driessnack 2010;Engh Kraft and Eriksson 2015;Joyner 2012;Land and Barclay 2008).Good communication between…”

“…This theme specifically addresses the second objective of the review: what barriers exist to school nurses protecting children and young people from maltreatment? The first barrier involved reporting children and families to social care or other agencies, which nurses in six studies felt was difficult when the child, young person or family may disengage, be at seemingly greater risk than before, or if the concerns were found to be incorrect (Alizadeh et al 2011;Eisbach and Driessnack 2010;Engh Kraft and Eriksson 2015;Engh Kraft et al 2016;Land and Barclay 2008;Schols et al 2013). School nurses in one study found sexual abuse particularly difficult to address as it was 'private' and 'taboo' and reflected how this might impact on their identification of such concerns (Engh Kraft et al 2016).…”

Shared responsibility: school nurses' experience of collaborating in school‐based interprofessional teams

“…The idea of creating a safety zone for pupils, parents and teachers echoes the findings of other studies in which the importance of SNs' availability and confidentiality was stressed . This part of the SNs' role was, however, not experienced as a straightforward expectation in the eyes of other school professionals and PH team members, and SNs worried that performing clearly expected duties, such as vaccinations and scheduled health dialogues, would leave them without enough time to create such a safety zone.…”