Alternative life styles: Relationship between new realities and practice

This paper discusses the relevance to clinical practice of current research on alternative family life styles. Attention is focused on therapists' countertransference reactions which interfere with the course of therapy. Source of information is an interdisciplinary research program at the University of California, Los Angeles School of Medicine, on the development of 200 children in four family styles: single mothers; from triads to large communes; and, a comparative group of traditionally married nuclear families. These alternative life styles emerging from the counter-culture may be altering patterns of family dynamics and functioning. Awareness of such changes is essential to clinical practice.     

‘Now I See The Difference’ — The Use Of Visual News Of Difference In Clinical Practice

Differences between events, values, attitudes and relationships provide therapists with the most meaningful data in the search for a circular perspective. Systems change is believed to be dependent on the reception of relevant information by the system. Traditionally, information has been collected verbally and Tomm (1984) outlines a schema of the types of difference questions. However, clinical practice suggests that these questions are not suitable to all clients. Difference questions may be confusing and unproductive when working with young children whose language skills are not fully developed and auditory memory limited. Adults whose verbal skills are limited or whose primary mode for processing information is not auditory, also have difficulty. An alternative visual method for collecting news of difference is proposed, using Tomm's (1984) categories as a basis. Case examples are given of this technique, at the stage of data collection and as a way of marking and reinforcing change through the course of therapy.     

Depression and Parenting by Nonoffending Mothers of Children Who Experienced Sexual Abuse

Parenting may be one mechanism by which depression in nonoffending mothers impacts child emotional and behavioral adjustment after sexual abuse. This study examined the relationship between self-reported maternal depression and parenting behaviors by nonoffending mothers of children who experienced sexual abuse. The participants were 204 nonoffending biological mother–child pairs recruited from a clinic providing services for children who experienced sexual abuse. The mothers completed pretreatment self-report measures of demographic information, depression, and parenting behaviors. Children (7 to 17 years) completed a measure of mothers’ parenting behaviors. Mothers with clinically high levels of self-reported depression employed more inconsistent parenting behavior and provided poorer monitoring/supervision of their children than mothers without clinically high levels of self-reported depression. Implications for clinical practice and future research are discussed.     

The intersection of home study assessments and child specific recruitment: the performance of home studies in practice

Child specific recruitment efforts are designed to facilitate permanent placements for children in foster care by finding them potential adoptive families among people already known to the child. This process relies heavily on gathering thorough and accurate information about prospective families, and much of this information is often contained in families’ home study assessments. Yet, little is known in the research literature about the way that home studies operate in conjunction with the recruitment of adoptive families. The purpose of this study is to explore how home studies are perceived and used in the context of child specific recruitment. Findings suggest that home studies perform best in gathering general family information, but poorly in capturing sensitive information, which may be one of the most critical dimensions to capture. These findings highlight important practice changes needed in current adoption practice.     

Sibling kinnections: a clinical visitation program

The growing literature on sibling relationships throughout their lifespans is of great importance to those working in the child welfare system, and in adoption services in particular. Sibling bonds are important to all of us, but they are particularly vital to children from disorganized or dysfunctional families. These relationships assume even greater importance when children from these families enter the care system. Supporting and sustaining these sibling bonds should be, and most often is, a priority throughout the child welfare system, with practice literature providing guidelines for arranging and sustaining sibling contact. However, children in the care system may also have dysfunctional sibling relationships as a result of their early experiences, and sibling visitation alone may not be enough to ensure a healthy, long-lasting relationship among siblings. Some form of sibling therapy, or 'clinically supervised visitation,' may be required to help children remove the barriers to form mutually satisfying relationships and to reinforce life-long relationships with each other.     

Children and Families’ Involvement in Social Work Decision Making

This review summarises the research literature on children’s and parents’ involvement in social work decision making, which is regarded, in policy terms, as increasingly important. In practice, however, it tends to be messy, difficult and compromised. Different individuals or groups may have different understandings of participation and related concepts, while differences of age and disability also mediate effective user engagement. The literature highlights common themes in effective participatory practice with both children and their parents. Central to this are the establishment of relationships of trust and respect, clear communication and information and appropriate support to participate.     

Specialist assesstnent services for child abuse and neglect

This paper describes the Child Protection Service, Flinders Medical Centre, South Australia, a specialist assessment service for infants, children and adolescents following allegations of abuse and neglect. The psychosocial and medical services provided for infants, children, adolescents and their families are outlined briefly and the Child Protection Service's view that the assessment process can and needs to be therapeutic is discussed. Data was provided about the age and gender of infants, children and adolescents seen and the number of families referred on for longer-term therapeutic intervention. The unit's philosophical stance, affecting its clinical practice and interagency and consultation service, is described, as is its research focus. The paper also raises a number of issues that warrant further and detailed attention. These include the need for workers to monitor and attend to their emotional responses while working in the area of abuse and the destructive potential of denial that may consequently and subtly impact on professional practice. The tendency for professionals and the wider society to ignore the impact of physical abuse is also raised.     

Agency and its Constraints among Biological Children of Foster Carers

There is currently limited understanding of biological children of foster carers and their experiences of foster care placements. This article presents findings from focus groups with biological children that shed light on their perspectives and experiences. Findings indicate biological children are competent social actors who contribute to, and seek to influence, the care environment in their homes. However, due to a lack of recognition, information, and support, biological children’s agency is constrained and their challenges exacerbated. This article argues for increased recognition, information and support for biological children, advocating for a “whole-of-family” approach to foster care practice and policy.     

A window on the wider world? Rural children's use of information and communication technologies

The possibilities which information and communication technologies (ICT) offer people (or groups) to overcome the friction of distance and the constraints of materiality mean that these technologies are seen to have particular relevance in rural areas which have been historically characterised in terms of their economic and social perpheriality. In this paper, we draw on empirical research with children and their teachers and parents, to explore the opportunities which ICT are seen to offer young people living in rural areas. First, we examine the information that children access on-line and how young people make sense of this expanded terrain. Second we focus on communication, by considering children's use of email and chat rooms. Third, we explore how this information and these modes of communication may be shaping young people's sense of place in the world. Our findings expose a clear contrast between the ambitious and future orientated ways in which adults imagine ICT will expand their children's educational and employment opportunities, and social and spatial horizons, and the everyday ways in which these technologies actually emerge for children in practice.     

Designing Computerized Clinical Information Systems to Monitor Interventions on the Agency Level

The aim of this paper is to suggest an approach to the design of computerized clinical information systems to help meet the information needs of practitioners in social service agencies. Further, the interest is in data that can and should be collected as integral part of practice and not as part of one-shot research endeavors. This paper presents a brief analysis of what outputs a clinical information system should produce in order to meet information needs of clinicians, and suggests guidelines for the design of such systems. Two applications of information systems based on these guidelines are presented and discussed. In the discussion, the paper identifies the need for programming tools which would faciliate the interface between practitioners and data base programs. Finally, the implications of the availability of this information technology for clinical judgment and for individualized interventions are briefly discussed.     

Predictors of attachment styles of children in foster care: an attachment theory model for working with families

The purpose of this study was to examine the attachment styles of children in foster care and to use this information to inform clinical practice (N = 110). When examining the relationship between attachment style and child characteristics, no significant differences were found. A structural equation model hypothesizing the relation of individual characteristics, losses, and family contact to avoidant attachment was then tested. Results provided tentative support for the hypothesized model. Implications for therapists include being attentive to attachment injuries, and working to create safe therapeutic environments when working with families involved in the foster care system.     

Treatment Outcome Research: How Effective Are Treatments for Abused Children?

The effectiveness of treatments with abused children is supported by only a limited number of studies. Yet despite the lack of an empirical base, many interventions remain popular in clinical practice. This paper introduces social work clinicians to the primary issues involved in the evaluation of psychotherapy with children and adolescents in general, and applies these issues to an understanding of interventions with abused children. Toward this end, current findings on child abuse treatments are synthesized and critically analyzed. This paper speaks to the continuing gap between empirically-based outcome research and clinical practice.     

Can a Munro-Inspired Approach Transform the Lives of Looked after Children in England?

This discussion paper will examine the lessons from the Munro Review relevant for looked after children. Although the Munro Review focuses on child protection, we will argue that some of its key principles have relevance for understanding looked after childhoods. The Munro Review provides an analysis of the current state of the child protection system, challenging bureaucratised practice and arguing for a reclaiming of professional social work identity, knowledge and understanding. There are three key principles of the Munro Review that this paper will focus upon. The first two are the recognition that risk cannot be eradicated and the bureaucratisation of practice is an inadequate response to the demand for public accountability. The third principle is that ethical integrity lies at the heart of services for children in public care. The key message of this paper is that a Munro approach can transform looked after childhoods. However, the current ‘child protection’ model of social work in England may prevent this shift in social work practice.     

The Impact of Clinical Information Systems on Human Service Organizations

Summary

Human service organizations are beginning to utilize computerized information systems for a variety of purposes. This new information technology is expected to have a major impact on human service organizations. However, work to date has explored the impact of information systems designed for administrative and managerial tasks while clinical information systems focusing on direct practice have yet to be studied systematically. In this paper, is described the impact of a clinical information system on the work of line workers and the HSO as a whole. Five stages in the problem solving process are identified: Information collection, information processing, professional judgment, decision making, and action. They are viewed as stages in a feedback loop such that die action sequence of one cycle leads to an information collection stage in the subsequent cycle and so on. The possible impact of a CIS on practitioners at all levels from line worker to HSO clinical leadership is analyzed at each of these five stages. A case example of the CIS developed for the foster care service in Israel is utilized as an illustrative example.     

Post-traumatic Stress Disorder in Childhood Sexual Abuse: A Synthesis and Analysis of Theoretical Models

The notion that post-traumatic stress disorder (PTSD) may be found in children who have experienced sexual abuse has become an important issue in research and clinical practice. To date however, there is a lack of consensus on what theoretical model(s), if any, best account for PTSD within this population. As a way of contributing to the existing body of literature pertaining to PTSD and its relationship to childhood sexual abuse, this paper synthesizes and presents a critical analysis of contemporary theoretical models.     

Family‐Focused Child Therapy in Marital Separation

When marriages and long‐term relationships break down, parents may refer their children and adolescents to therapy for a variety of reasons. While the systemic therapist's preference may be to work with the family system/s, high conflict separation may prohibit such an approach. This article discusses family‐focused child therapy that prioritises the needs of children while seeking to preserve a systemic approach. At a practice level this may involve: (a) individual child therapy, (b) engaging with smaller subsystems including siblings, (c) joint therapeutic work involving child/ren plus parent/s, and (d) any of these combinations; all while continuing to maintain a systemic understanding of the work. The article discusses the challenges of working with children from separated families, where there is restricted or no possibility of engaging with the broader family system.     

Teaching a Child With Autism to Mand for Information Using “How”

Children with autism often do not learn to mand for information without structured teaching. Studies have demonstrated that manipulation of establishing operations (EOs), prompts, prompt fading, and differential reinforcement are effective in teaching children with autism to ask "wh" questions such as "what," "who," and "where." To date, no studies have evaluated procedures to teach children with autism to mand for information using "how." Teaching the mand, "how" is uniquely challenging because once the information regarding how to do something is provided, the EO may no longer be present. The following study evaluated a procedure to teach one child with autism to mand for information using "how" to obtain information to complete multiple activities. The results have implications for clinical application and future research on contriving EOs to teach the mand, "how."     

The Lull of Tradition: A Grounded Theory Study of Television Violence, Children and Social Work

This article results from a study of television violence and social work practice with children. Twenty-one social workers who work primarily with children in schools, in community mental health agencies and in private practice were interviewed. A qualitative analysis using grounded theory indicates that social workers do little to elicit television content or information about children's television viewing. They do not believe that television experiences are central to their work. Although social workers express concern about the influence of television violence on children, their traditional beliefs in cause and effect, values neutrality, and gender lead many to minimize its importance.     

Integrating self-care into clinical practice with trauma clients

ABSTRACT

Self-care is recognized as an important aspect of social work practice. Beginning in educational settings, developing social workers are encouraged to learn about and practice self-care. However, self-care is typically promoted through strategies and approaches outside of the practice context. Social workers are oftentimes encouraged to use individualized self-care plans, which often feature a variety of relaxation and secondary techniques; focus on self-awareness and self-reflection; and have proper use of supervision. Although these strategies are invaluable, they do little to directly benefit the social worker during direct practice or while in session with a client which is a time period when clinicians are particularly vulnerable to distress or burnout. The importance of real-time self-care strategies is particularly critical for clinicians, especially those who engage in trauma work, given the sensitivity of topics that clients may have endured or benefit from assistance in processing. Further, little information has been published on the use of self-care techniques during a session with a client or in a clinical context. The purpose of the present paper is to discuss self-care strategies that can be useful both outside of and within a clinical setting and present a model of such strategies that focus on integrating self-care in clinical practice particularly for those engaging in trauma work. The paper will conclude by discussing the relevancy of the developed model in practice.     

Investigative vs. Clinical Emphasis in Child Custody Evaluation: A Reflection on Austin and Kirkpatrick(2004)

ABSTRACT

There is an ongoing discussion regarding the role of psychologists in child custody relative to clinical vs. investigative roles. The issues revolve around how expansive or how limited a professional might be in addressing the concerns of families, adults and children in high conflict custody cases. In the article, the investigative or more maximalist role is discussed in the light of the alternative more clinical or minimalist stance. An argument is advanced that we may be limited to a more clinical/minimalist role if we are to stay within the confines of research informed practice standards.