Breaking ground,hitting ground: A Sure Start rapid response service for parents and their under fours

This paper describes a project aimed at taking an under fours' counselling and parent support service into a neighbourhood characterized by particularly high levels of deprivation and ethnic diversity. Referrals to the local CAMHS showed a high level of disturbance in school aged children and adolescents in this area. However, children under 4 years were strikingly under-represented in referral statistics, suggesting the need to make our service more accessible to this group. The project took the form of a once-weekly clinic run in a community centre. Differences in ways of engaging and working with the families in order to make the service accessible and ‘user friendly’ are described. So, too, is a protocol developed in order to support the worker in thinking through the many anxiety raising situations to be responded to in dealing with severely deprived families living in extremely stressful situations. Three clinical examples illustrate that a major value of this initiative was in increasing the worker's understanding of ethnic and cultural differences and of how to work with them. The service also helped to promote good liaison between statutory and voluntary agencies. The project was established initially under the auspices of Sure Start, a government sponsored scheme for enriching developmental opportunities of under fours and their parents in deprived areas. After running for 18 months, it will be funded through mainstream resources, as an example of the kind of innovative work with hard to reach populations encouraged by the guidelines given in the new National Service Framework for Children in England.