Psychoeducational groups with foster parents of sexually abused children

Psychoeducational groups for foster parents of sexually abused children were successfully delivered. Groups with nonrelative foster parents required less basic behavior management training than groups for foster parents related to the children in their care. Relative groups also required considerable attention to issues of visitation with birth parents. The groups helped foster parents improve their ability to care for sexually abused children. Participants were highly satisfied with the groups. Additional program development and research is clearly warranted.Ms. Winterfelt is in private practiceThe Project was supported by the Children's Bureau, ACF. DHHS.Copies of the training curriculum and videotape are available from Ms. Yeaton, Dept. of Psychiatry, Children's Hospital, 747 52nd Street.     

Behavior Problems of Sexually Abused Children in Foster Care

Research has shown that sexually abused children display a number of behavior problems. Many of these children are placed in substitute care, especially foster homes. The current project was undertaken to measure foster parents' perceptions about the behavior problems of sexually abused children in their care. Two studies were completed. The first was a large survey of foster parents in a Midwestern state. The second study utilized a sample of foster parents to complete a standardized behavior inventory which has previously been used in child sexual abuse research. The types of behavior problems described by foster parents and implications for future research are discussed.     

Parent-child interaction therapy: application of an empirically supported treatment to maltreated children in foster care

One of the more serious problems faced by child welfare services involves the management of children with serious behavioral and mental health problems. Aggressive and defiant foster children are more likely to have multiple foster care placements, require extraordinary social services resources, and have poor short- and long-term mental health outcomes. Interventions that work with challenging foster children and enhance foster parents' skills in managing problem behaviors are necessary. This article presents the successful results of a single case study examining the application of Parent-Child Interaction Therapy (PCIT) with an aggressive young boy and his foster-adoptive parent. PCIT is a dyadic intervention that has been identified as an empirically supported treatment for abused children and for children with different types of behavioral disruption. The application of PCIT to assist foster parents is a promising direction for child welfare services.     

Relative foster parents of HIV-affected children

The HIV epidemic is one of the reasons for an increase in relative foster care. Most children of HIV-infected parents are not infected, but both the children and their caregivers are affected by the parent's illness. Twenty-eight caregivers participated in an exploratory, qualitative study of the permanency planning needs of HIV-affected relative foster parents. Of the caregivers, 17 disclosed that the foster child's parent was HIV-infected; 11 caregivers did not report HIV infection in the immediate family. HIV-affected caregivers' greatest need was a more adequate response from social workers and therapy services for the children; nonaffected caregivers needed financial assistance most. More HIV-affected caregivers were considering permanency than nonaffected caregivers. Child welfare workers and relative foster parents need training on HIV's effect on the families so that appropriate services can be accessed as early as possible.     

Externalizing problems in young foster children: Prevalence rates,predictors and service use

Objective

Examining the prevalence of externalizing problems, their predictors and mental health service use for these problems by foster children and foster parents in a representative group of foster children aged 3 to 12 in Flanders.

Method

Survey data were collected on 212 foster children, who had been in the foster family for approximately four months. Foster parents filled out a Child Behavior Checklist to measure foster children's externalizing problems. Foster care workers reported on several potential risk variables for externalizing problems and on foster children's and foster parent's mental health service use. Predictors of externalizing problems were identified from a large number of variables using the method of purposeful selection of variables in linear regression.

Results

40.6% of the foster children had externalizing problems. Foster children who were placed because of behavioral problems had more externalizing problems. Only 20.9% of the foster children with externalizing problems and only 13.9% of their foster parents received professional help.

Conclusions

This study showed that externalizing problems are prevalent in this young foster care population, that it is hard to predict which foster children had externalizing problems, and that foster children and their foster parents rarely receive services for these problems. These findings call for a standard protocol of assessment of foster children's externalizing problems. Moreover, from a preventive viewpoint, guidelines are needed to systematically link young foster children with externalizing problems and their foster parents to appropriate services.     

From the Mouths of Mothers: Can Drama Facilitate Reflective Learning for Social Workers?

This article explores and evaluates a cross-disciplinary small-scale project using applied theatre in social work education. The aim was to provide an ‘Affective Encounter’ where students could practice empathic engagement, understanding of the needs of children who have been sexually abused and their protective parents/carers and engage in the complexities of working with family members who may be resistant. The workshop took place five times over a period of three years and was attended by children and families social workers on a one year post-qualifying graduate diploma course. While the use of verbatim theatre does not offer a guarantee of factual truth, it provided the students with some performed moments of personal testimony which was taken word-for-word from mothers whose children had been sexually abused. This allowed the social workers to hear the marginalised narratives of the protective mothers and to practice without a negative impact on the service user. The evaluation identified from self-report the development of emotional and practical skills and knowledge of available resources. This paper focuses on the emotional skills reported and two emerging themes are discussed: learning for humane practice, and the use of this pedagogical approach to encourage affective reflection.     

Mix and match: planning to keep looked after children safe

The risks which children run from other children in substitute care have received little attention. However, if children's safety in care is to be maximized, then placement planning will need to focus on the risks and vulnerability of both the child to be placed and others already in the setting. It should also ensure that full information is given to the caregivers. In an interview sample of 40 looked after sexually abused and/or abusing young people aged 10 or over, most of the young abusers were placed in foster care and the majority of the sexually abused young people went into children's homes. However, in fewer than a third of these placements was consideration given to how the young person would fit in with others in that setting. This meant that the potential risks which that child posed to others or vice versa were not addressed. More worrying still, in just under half of the sample, no information about the young person's history of sexual abuse or abusing behaviour was given to the caregivers. This meant that caregivers were unable to plan to provide the level of supervision which might have averted a number of instances of abuse. When the whole histories of the sexually abused young people in the study were examined, it was found that half of them had abused another child at some stage, generally another child in care. This evidence suggests that the experience of sexual abuse should be regarded as an important risk factor in the later development of sexually abusing behavior and that local authorities need to fashion policies which emphasize the prime importance of social workers providing full information about children's backgrounds when placements are made. Copyright © 1999 John Wiley & Sons, Ltd.     

South African social workers' knowledge of attachment theory and their perceptions of attachment relationships in foster care supervision

Despite the prominence of attachment theory in international foster care literature and the importance of attachment relationships in successful foster care, attachment theory and practices do not feature prominently in South African foster care research. Against this backdrop, we interviewed twenty South African social workers' about their knowledge of attachment theory and their perceptions of attachment relationships in their own foster care work. Thematic analysis was used to analyse the interviews. We found that the social workers had limited knowledge of attachment theory and interventions; experienced most biological parents as unmotivated to improve their circumstances and attachment relationships with children; indicated that family reunifications were rare occurrences; reported foster parents were mostly kin; and experienced constraining contextual factors that hindered optimal consideration of attachment relationships in foster care supervision.     

The Relationship Between Parent and Child Reports of Parental Supportiveness and Psychopathology of Sexually Abused Children

This study examined the relationship between parent and child reports of supportiveness of intrafamilially sexually abused children and levels of child psychopathology. Fifty-four intrafamilially sexually abused children completed a revised version of the Family Subscale of the Survey of Children's Social Support and the Child Assessment Schedule. Fifty-four parents completed a version of the Family Subscale of the Survey of Children's Social Support, modified for use in parental reporting of their own supportive behaviors. Satisfactory reliability levels were obtained for the revised measures. This study of 54 sexually abused children and their non-offending parents found that although most non-offending parents were supportive of their children, the children reported considerable distress. Although there was no significant difference in mean levels of support reported by parents and children, the two measures were not significantly correlated. This suggests that parents and children perceive supportive behavior differently, although both constructs are of importance. Multiple regression analysis found that both child and parent reports of parental support were predictive of levels of child psychopathology, but that child estimates were a stronger predictor.     

Psychological and Physical Health of Nonoffending Parents After Disclosure of Sexual Abuse of Their Child

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers’ mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers’ health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.     

Improving Relationships in Child Welfare Practice: Perspectives of Foster Care Providers

Foster parents care for our nation’s most vulnerable children and adolescents. Their ability to provide care is impacted directly and indirectly by their interactions with public child welfare agencies and workers. This study examines the perspectives of 1095 foster parents in a southwestern state in the U.S. regarding what they believe child welfare workers are doing well and their suggestions for ways to improve relationships between foster care providers and child welfare workers. Foster parents commended caseworkers who were responsive to their needs and provided ongoing concrete and emotional support, and believed there was a need for improved communication and enhanced teamwork. Foster parents consistently acknowledged an overwhelmed child welfare system and the impact on child welfare workers and child welfare-involved families. Understanding the perspectives of foster parents can improve relationships between child welfare workers and foster parents, improve recruitment and retention efforts of foster parents, prevent disruption of children from foster homes due to license closure, and improve the overall well-being of child welfare-involved children and families.     

Child Sexual Abuse Workers’ Emotional Experiences of Working Therapeutically in the Western Cape, South Africa

South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers’ emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world. This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews. There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants’ ways of managing sexually abused children’s material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions. To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.     

Abused children and foster care—the need for specialist resources

Estimates vary on how many abused and neglected children are admitted to care and how many children in care are there because of abuse and neglect. Nevertheless, it is important to examine their special needs and the problems they present to carers. Although research findings are difficult to interpret, there is enough evidence to show that abused and neglected children in care have special needs in three particular areas: education, health and social behaviour. The evidence is available from research into children in care and research into child maltreatment. Children in care run the risk of disrupted educational careers; abused and neglected children have additional problems in school. Many children in care have a patchy and neglected medical history; abused and neglected children are seriously at risk of further ill-health. Abused and neglected children have been shown to have behaviour problems that jeopardize their relationships with peers and adults; they run the risk of placement breakdown. Foster care of abused and neglected children is a specialist and demanding task, requiring knowledge of, and sensitivity to special needs. Because many abused and neglected children return to their parents, foster carers also need to include the natural family in their task. High expectations of these foster carers, however, should not lead to exploitation but rather an enhancing of fostering assessment, preparation, support and training.     

Sexual and reproductive health policies for foster youth in California: A qualitative study of child welfare professionals' experiences and perceptions of policies

Child welfare professionals and foster parents increasingly suggest the importance of establishing clear and consistent policies and procedures to address the sexual and reproductive health of youth in foster care. The present study examines the content and context of such policies across 18 California counties through a search of publically available county policy documents, and surveys and expert interviews with child welfare professionals (N = 22). A policy framework for agenda setting and policymaking was used to guide the data collection and analysis process. Child welfare professionals were aware of multiple sources of information, support and services for foster youths' sexual and reproductive health, though few practiced in counties with formal policies that outline the resources and support that youth should receive. Participants demonstrated widespread recognition that issues of youth sexual and reproductive health were significant; posing challenges to youth, foster parents and child welfare staff. Identified policy solutions included: 1) training for social workers and foster parents; 2) collaborative partnerships with public health nurses and community providers; 3) data tracking and monitoring of outcomes to assess youth needs and evaluate the impact of programs and policies; and 4) involvement by advocacy organizations in defining problems and advocating for improved services and support for youth in care. Social workers largely perceived that support from child welfare administrators and policy leaders is necessary to prioritize this issue and initiate policy formation. Additional research is needed to further examine the impact of policy mandates on social workers, foster parents and youth in foster care.     

The Dialectic of Chaos and Control in the Experience of Therapists Who Work With Sexually Abused Children

The aim of this study is to contribute to the understanding the interaction between the emotionally destructive intensity of the trauma and forces that foster growth in therapists who treat sexually abused children. Data were collected through in-depth semistructured interviews with 14 experienced social workers. Content analysis reveals two emotional poles. At one pole, the dominant experiences are anxiety, turmoil, and intrusion that disrupted the order in the interviewee’s secure world. At the opposing pole, the dominant experiences are positive, such as hope and faith. These formed the basis of empowering meaning construction that engendered a sense of control, enabling the therapists to trust the value of intervention with sexually abused children. The discussion uses a dialectical perspective to examine how interaction between these two poles enhances our understanding of the emotional and existential threats inherent in working with children who have experienced sexual abuse and on the potential for positive change.     

Characteristics of Four Kinship Placement Outcome Groups and Variables Associated with these Kinship Placement Outcome Groups

This study investigated factors that might be associated with the disrupted kinship care placements of abused and neglected children. Data were collected from face-to-face interviews of 130 kin caregivers who were randomly selected from lists provided by two child protection agencies and divided into four different outcome groups. Findings of the study revealed that characteristics of the children such as their health status, ages, and the extent to which they were getting into “trouble” were significantly associated with placement outcomes. The caregivers’ perceptions of the quality of relationships between themselves and the children in their care and the birth parents of those children were also associated with placement outcomes. Two other factors affecting outcomes were the frequency of contact between social workers and caregivers and the extent to which services plans were discussed. Practice implications related to these findings are discussed.     

The language and policy of care and parenting: Understanding the uncertainty about key players’ roles in foster care provision

Recent debates about the care provided to looked-after children have been characterised by uncertainty about the differing roles and responsibilities of foster carers, birth parents, and social workers. To explore the assumptions underlying these uncertainties, we drew upon Foucauldian Discourse Analysis and compared the discourses used by professionals (social workers in a group discussion about foster placement breakdown) with those used by policy-makers (in the Governmental green paper ‘Care Matters’). In both cases, a discourse based upon Attachment Theory was used to explain why placements succeed and fail, and to predict the repercussions of failure. However, there was a key difference in the way that professionals and policy-makers constructed the roles of key players in foster placements. The social workers constructed the birth parents as the parental figures for children in care, constructing themselves in a non-parental role. ‘Care Matters’ largely ignores the role of birth parents, and instead constructs social workers as parental figures. Neither source viewed foster carers as parental and ‘Care Matters’ positions this group as strictly professional. We discuss the incongruence of foster placements being understood through Attachment Theory, while foster carers are understood as non-parental figures, and also the repercussions of labelling a social worker as a parent, and the professionalization of the role of the foster carer.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

“I want to be there when he graduates:” Foster parents show higher levels of commitment than group care providers

Group care is a frequent placement for adolescents placed in out of home care when their birth parents' care is deemed unsafe. In the present study, we assessed whether foster parents show greater commitment to children than group care providers. Given that group care represents a number of living arrangements, we considered both shift care (where staff work shifts and do not live with the children) and cottage care (where staff live for extended periods of time with the children in a group living context). Commitment was assessed using the This Is My Child Interview (adapted for adolescents). Thirty-one foster parents, 18 shift workers, and 28 cottage care providers were interviewed. As predicted, foster parents showed higher levels of commitment than both shift care workers and cottage care providers, and the associations held when children's externalizing behaviors and the number of children the caregivers had cared for were controlled. The results suggest that foster care promotes greater commitment among caregivers than other out of home placements, and add to other findings that favor foster care as the out of home placement of choice for adolescents.