Therapeutic work with children and their families is challenging and situations where children have been hurt by those entrusted with their care is both personally and professionally confronting. Non-judgmental care is often easier said than done.
Recognizing that there is limited literature defining this concept and its implementation in clinical practice, Twigger et. al. (2025) undertook a pilot narrative review exploring barriers and facilitators from the perspective of both clinicians and lived and survivor perspectives. The research spanned 2014 to 2024 and included eight studies of the clinician’s perspective and nine lived experience studies.
What Impacts Clinicians?
Five themes were identified which appear important to non-judgemental care. These were responsiveness and attributes which included empathy, safety, tolerance, persistence and respect, the adoption of strength-based approaches, maintaining curiosity in the context of uncertainty and complexity, power differences and unconscious processes.
Lived Experience and Survivor Perspectives
For this group a key quality which facilitated non-judgemental care was listening and attunement whilst shame and barriers like limited knowledge and capacity, inconsistency and poor organisational support hindered therapeutic engagement.
Historical Trauma
Working with children and their families where abuse has occurred requires a broad social and historical lens that incorporates an understanding of historical trauma. In some cases, ‘Clinicians may be limited in their cultural competence, but also in how they serve, understand and fully engage with communities of historical minority status’.
The Application in Clinical Practice
bower(note) the processes and protocols that underpin all work done at Bower Place is powerfully influenced by the work of philosopher John Rawls. Rawls ‘A Theory of Justice’ proposed that justice was linked to fairness and a just society was one where each person was ‘treated with fairness and recommends equal basic liberties, equal opportunities to similar individuals, and offering the highest possible benefits to the less advantaged members of society.’
These principles are made manifest in protocols which ensure the most unequal person in any therapeutic exchange is protected. Inequality may be due to inside neurobiological factors like processing capacity or autism or outside experiential or opportunity issues like trauma and education.
These protocols become increasingly important the greater the inequality between practitioner and client and the more likely that practitioner will be required to exercise their statutory authority. In matters of abuse and violence this is often required.
Managing inequality and ensuring all parties experience the exchange as being just to them is a practical and achievable way to promote non-judgemental care.
Twigger, A., Lee, A. Y. S., & Amos, J. (2024). Clinician and lived experience perspectives on non-judgemental family care, in working with childhood maltreatment and intergenerational trauma: A pilot narrative review. Australian and New Zealand Journal of Family Therapy, 45, 388–400. https://doi.org/10.1002/anzf.1611
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