Pre-foster Care Maltreatment Class as a Predictor of Maltreatment in Foster Care

The majority of youth in the foster care system have been removed from their homes as means of protection against parental maltreatment. Studies have shown, however, that foster youth may continue to experience maltreatment after they have entered the child welfare system (Poertner et al. in Child Youth Serv Rev 21(7):549–563, 1999; Tittle et al. in Urbana 51:61801, 2008). In this study, we explore how maltreatment prior to foster care entry may predict maltreatment while in care for youth who are preparing to emancipate. Using latent class analysis and multinomial logistic regression, we find that current or former foster youth with histories of multiple maltreatment (particularly, combined pre-foster care histories of neglect and physical abuse) are more likely to report neglect, physical abuse and sexual abuse in care than those with histories of low maltreatment. These youth should be the target of prevention efforts in child welfare agencies.     

“A Very Steep Climb”: Therapists’ Perspectives on Barriers to Disclosure of Child Sexual Abuse Experiences for Men

ABSTRACT

Recent studies indicate that men experience unique barriers to disclosure of child sexual abuse. Blind spots held by mental health providers and social service agencies may inadvertently help produce and sustain these barriers. However, therapists who specialize in treating this population may also hold important insights into the barriers clients face. Because delayed and nondisclosure of child sexual abuse have been associated with negative mental health outcomes for adult survivors, understanding these barriers is critical to improve clinical practice and facilitate help-seeking. Using conventional content analysis, this study examined the perceptions of nine therapists who specialize in the treatment of men who were sexually abused in childhood, many of whom are considered pioneers in the field. Analyses identified nine types of barriers, which were organized into three categories: intrapersonal experience (difficult feelings, lack of language, and self-engagement), social milieu (internalized social stigma, negative responses, social loss or judgment, and masculine identity dissonance), and health care environment (structural barriers, relational challenges with therapists, and unhelpful therapeutic strategies). Implications for future research, clinical training, and clinical practice are discussed.     

Evaluation and assessment

The current debate about the balance between child protection and family support, informed by the publication of a sequence of government sponsored research studies, tends to focus on the investigative stage of child protection relating to Section 47 of the Children Act 1989 and contrasts this with the less stigmatising approach of assessment and support to the families of children in need under Section 17 of the Act. Little attention has so far been paid in Government documents and guidance to the child protection process after the initial investigative stage. The work of the core group, set up by the child protection conference when a child's name is placed on the register, is, however, the main vehicle for the implementation of the plan to protect the child(ren) at risk in a family and marries the twin strands of protection and support.

Because of the pressures on training and staff development sections of Social Services Departments, as well as on academic institutions offering social work courses to meet the mandatory requirements of CCETSW and of the Training Support Programme, training and education relating to core groups have been afforded low priority in most authorities and universities.

Research suggests that there is great potential for prevention, for family support and for positive work with children and their families in this area of work. A recent national conference suggested models for progressing good practice. A pre-conference questionnaire was completed by conference participants and is to be extended to all local authority Social Services Departments to collect information on current practice and procedures.

Training Issues include the following:

• 1. partnership practice with both family members and professionals;

• 2. communication with children and young people and other family members;

• 3. power and issues of difference;

• 4. clear and detailed planning, monitoring and review;

• 5. user perspectives.

Some examples of professionals' and service users' views will be given as well as suggestions for a framework and strategy for training in this area.     

Where can I mourn? Psychodynamic contributions to working in residential child care

ABSTRACT

Loss permeates the experience of being placed in residential child care, yet residential workers are rarely trained to work with young people who are grieving the loss of family and home. This article will provide an overview of psychodynamic theories of mourning, and will discuss how grief work can be facilitated for children and youth in residential child care.     

Clients’ perceptions of marriage and family therapists’ way‐of‐being: a phenomenological analysis

Previous research highlights the influence of therapist factors on treatment outcomes. One therapist factor proposed as fundamental to the process of therapy is the therapist's way‐of‐being, a relational concept that refers to how the therapist regards a client—either as a person or object (Fife et al., [2014] Journal of Marital and Family Therapy, 40, 20–33). Although this case has been made conceptually, there is little empirical research on therapists’ way‐of‐being with clients. The primary purpose of this research is to investigate clients’ perceptions of their therapists’ way‐of‐being. Utilizing a common factors perspective, the study seeks to explore: (a) how clients experience their therapists’ way‐of‐being and (b) the influence therapists’ way‐of‐being has on clients’ engagement. Phenomenological methods were used to gain a nuanced understanding of the phenomenon. Qualitative data were collected through semi‐structured face‐to‐face interviews with clients (N = 10) who received individual therapy from a marriage and family therapist. Results were organized into two main themes: core tenets (attunement, congruency, and aligning with clients) and operational tenets (providing affirmation and validation, balancing flexibility and structure, and accomplishing goals). Findings are used to make a case for adding the concept of way‐of‐being as an overarching construct for several well‐established therapist factors. Clinical and training implications are discussed.     

Job-strain and well-being among Finnish social workers: exploring the differences in occupational well-being between child protection social workers and social workers without duties in child protection

Work-related mental distress and its impact on employees’ working life is a mounting issue among Finnish social workers. This article focuses on identifying the factors associated with child welfare social workers’ occupational well-being. The occupational well-being of Finnish child welfare social workers (N?=?364) and social workers whose duties do not include child protection work (N?=?524) was explored and compared with each other using t-test statistics and logistic regression analysis. The data, collected in 2014/2015, were obtained from an ongoing longitudinal cohort study on work-related well-being among Finnish public sector employees. A multi-dimensional and holistic approach to occupational well-being was used as the outline for the analysis and comparison of the two groups. Child protection social workers reported higher levels of burnout and secondary traumatic stress than social workers without child protection duties. Despite these burdens, both groups showed a similar level of general health, compassion satisfaction and overall occupational well-being. Individual and organizational factors associated with high occupational well-being were identified. Supervision was found to be an important supporting element. This study identified multiple determinants related to social workers’ occupational well-being, comprising positive and negative elements with regard to organizational and individual factors.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

Therapy with the whamere

The writer describes an experience of working with rural Maori whamere groups in the far north of New Zealand. It is suggested that therapists in such a context can choose to suspend their judgement and work in the existing cultural milieu. A case study is presented to illustrate the discussion.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Doing gender in public services: Affective labour of employment agents

The restructuring of state bureaucracies into service organizations and the new welfare state paradigm of activation have changed the work requirements of front‐line workers in public employment agencies across Europe. Public employment agents are less engaged in bureaucratic labour, but have to perform service work. They use affective means to motivate and to monitor and sanction jobseekers. This article provides evidence that these transformations in Austria, Germany and Switzerland did not suspend the gendering of public service work. We discovered four typical modes of affectively enacting the state: both male and female employment agents follow feminized service work patterns or masculinized entrepreneurial norms. To prevent a possible loss of their professional status, some employment agents reinterpret affective labour as professional service work that demands high expertise. Others resist the activation paradigm by performing traditionally feminized care work or by still adhering to affect‐neutral male bureaucratic work.     

Organized abuse: NSPCC experience

A survey of a national child protection agency's experience of organized abuse in 1990–1991 found awareness of incidents among 41% of the participants and direct involvement with children in 20%. The 19 cases where there was direct involvement with 61 children from 43 families were categorized by the workers as network (N = 10), ritual (N = 6) and child pornography (N = 3) and came from England, Wales and Northern Ireland. The children in the three types presented different profiles from each other and from that of the sexually abused children placed on child protection registers. The children in the network cases were more likely to be boys and abused by non-relatives, the majority of whom were charged and convicted. The children in the ritual cases were the youngest, more likely to be abused by extended family members and most often the subjects of legal protection. The inherent difficulties in fully describing an organized abuse ‘case’ are outlined.     

Studies in international social work

Studies in international social work is a joint report series between the Department of Social Work and INSWED (International Social Work Education and Development), both of which are at Stockholm University. The series was started in 2002 in order to reflect some of the international work relevant for social work that is being done by or in cooperation with these entities. It is open for ‘traditional’ academic work as well as international development cooperation projects. The research reports selected for publication in the series concern projects conducted in collaboration with Stockholm University and which can be expected to be of common interest to a wide range of readers. For this reason they are published in English. To date, the series has been devoted mostly to child welfare issues.     

Risk factors for mental health diagnoses among children adopted from the public child welfare system

Children awaiting adoption through the child welfare system often have “special needs,” or characteristics that make securing an adoptive home for them challenging. A subset of these youth experiences significant psychiatric symptomatology, which may pose a problem for the stability of the adoptive placement. Clinicians and policymakers require information about precursors to mental health difficulties in order to plan effectively for the placement of these children.This study examines potential child and biological family risk factors for the presence of a DSM-IV mental health diagnosis among 368 children placed for adoption by a special needs adoption program between February 1997 and April 2005 using logistic regression within the Generalized Estimating Equations (GEE) framework. A significant proportion of the children and biological parents in our study experienced serious adversity prior to adoptive placement. Older age at adoptive placement, white race, male gender, having more than one placement, and a history of sexual abuse are significant predictors of the presence of a mental health diagnosis in the logistic regression model. Biological parent incarceration is significantly associated with the absence of a mental health diagnosis.Adoptive placement is a key transition for youth who have often experienced significant loss and trauma prior to placement. Support of the adoptive family and youth can be critical to ensuring placement stability and may be especially salient for youth with documented mental health diagnoses and corresponding behavioral problems, which put children at increased risk for placement disruption. More work is needed to understand the interplay of risk and protective factors for mental health difficulties among youth adopted from the child welfare system, including how these are affected by child welfare policies, informal procedures, and resources to produce varying outcomes for children in peril.     

Youth with disabilities in the United States Child Welfare System

Existing literature suggests that youth with disabilities are known to be at increased risk of maltreatment in the form of abuse and/or neglect. Little is known, however, about the experiences of youth with disabilities who are living in foster care or who are supervised by child protection authorities. This study establishes a baseline estimate of the prevalence of youth with disabilities living in foster care, documents reasons for child protection system involvement, identifies placement types while youth are in care and explores case outcomes. This cross-sectional, exploratory study draws on data from the 2012 Adoption and Foster Care Reporting System (AFCARS) for foster youth in 50 states, the District of Columbia and Puerto Rico. A sample of youth with disabilities (N = 36.492) and a comparison group without disabilities (N = 601.539) were identified. Findings about demographics, reasons for child removal, foster care placements, permanency planning goals and case outcomes are presented. Findings have implications for the prevention the removal of youth from caregivers, the need for family supports to prevent foster care involvement, the promotion of community inclusion of foster youth while in foster care and the need for inter-system collaboration at the transitional age stage.     

Learning about child protection

Where do social workers acquire the knowledge they use in child protection work? What opportunities exist for them to access and use research? Should they bother? This paper addresses these questions using information provided by twelve local authority social workers involved in child protection work and findings from relevant research.

In a learning and work climate which appears not to encourage interest in research findings or knowledge from books generally, the paper considers both how knowledge from research might best be brought to the attention of busy workers and what are the necessary conditions for workers to develop and use knowledge in child care and protection practice.     

Social conservatism vs social justice: the portrayal of child abuse in the press in Victoria,Australia

This paper explores the role of the media in influencing child protection policies in the Australian state of Victoria. Media coverage of child abuse is seen to have had both positive and negative consequences. On the one hand, media campaigns have almost certainly helped to produce more equitable and effective child protection policies and practices. On the other hand, much media coverage (particularly in the tabloid media) has been sensationalist and simplistic. Such coverage arguably has a broader social conservative political agenda, which is to defend traditional institutions and values such as the family, rather than being primarily concerned with identifying necessary reforms to child protection policies and legislation. Attention is drawn here to the local coverage of recent high‐profile child abuse cases and debates within the two daily Melbourne newspapers, The Age and the Herald Sun. Evidence is presented to demonstrate that the tabloid Herald Sun has consistently pursued a broader social conservative agenda based on defending traditional nuclear families from allegedly subversive or deviant groups such as incompetent and/or authoritarian state social workers or, alternatively, individually abusive parents. In contrast, the quality daily The Age has generally eschewed simplistic coverage of individual cases in favour of broader structural reform agendas. Copyright © 2000 John Wiley & Sons, Ltd.     

Parting words: Trauma,silence and survival

Abstract

This article examines an enigma at the heart of Freud's work on trauma: the surprising emergence, from within the theory of the death drive, of the drive to life, a form of survival that both witnesses and turns away from the trauma in which it originates. I analyse in particular the striking juxtaposition, in Freud's founding work Beyond the Pleasure Principle, of his two primary examples of trauma: the repetitive nightmares of battle suffered by the soldiers of World War I, and the game of the child, faced with the loss of its mother, who plays fort and da (there and here) with his spool. My own understanding of Freud's insight did not emerge, however, simply through a reading of his text but began, in fact, in my encounter with a real child in Atlanta, a child whose best friend was murdered in the street and who is interviewed by the friend's mother. I thus read together the language of the nightmare and the language of the child in Freud's text, and then attempt to understand how Freud's text and the language of the real child shed light upon each other.     

A Framework for Healing from Loss

ABSTRACT

Many behavioral problems of youth may be viewed as complications with their grieving. This study investigates defenses which emerge in the face of repeated losses and trauma early in life and proposes a framework for understanding what is happening intra-psychically with youth who have such defenses. Inter-subjective and relational theory, early trauma theory, and social constructionist theory each inform this integrated framework for social work practice. Included is an extended cross-cultural case study of therapeutic work with a Latino youth in a community-based setting. Also included are clinical considerations for working with protective defenses emanating from early loss and trauma.     

Hierarchical relationship development: parents and children

Child growth and development occur in hierarchical relationships. In our attempt to work more collaboratively, family therapists have neglected to work toward developing theory that guides our work in such hierarchical relationships. This article describes a method for understanding child and relational growth. It builds on Wynne's (1984) epigenetic model of relational systems by integrating his model of family development with Bateson's (1958) concepts of complementarity and symmetry. Wynne's model defines a process for understanding the stages of relationship development, and Bateson articulates the process of change within a relationship. Utilizing principles from both theorists, this paper proposes that parent-child complementary relationships mature through Wynne's developmental stages via symmetrical struggles, and that these symmetrical struggles are necessary ingredients in the development of the relationships as well as of the individuals within those relationships.