The New Sisters of the Road: Homeless Women and Their Children

ABSTRACT

This article examines the growing social problem of homeless women and their children. It provides a historical perspective, reasons for the increased incidence of family homelessness, the negative effects of homelessness on women and children, and programmatic responses. It also makes recommendations for effective program services and policy reforms. It urges family social workers to adopt a policy advocacy orientation. The article concludes that there is a need for further research to separate causes from effects when studying homeless women and children, and that researchers need to attend to the significance of gender for the social problem of family homelessness.     

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Homeless children are a vulnerable group with high risk for developing mental health disorders. The pathways to disorders among homeless children have not been fully elucidated, with significant logistical and measurement issues challenging accurate and thorough assessment of need. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighborhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children’s mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilization, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioral problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children’s experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial riskfactors and emotional and behavioral symptoms of stress in homeless children, Twenty-two homeless nlothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children's experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial risk factors and emotional and behavioral symptoms of stress in homeless children. Twenty-two homeless mothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Remembering,Apologies, and Truth: Challenges for Social Work Today

Abstract

In 2003, over 41?000 families with accompanying children throughout Australia were assisted by homeless services. Sole fathers with children in their care who are homeless are a minority group within this overall population of homeless families and, as such, little is known about their experiences of homelessness and fathering. The present paper reports on an exploratory study of sole fathers with children in their care who were homeless in the Australian Capital Territory. The study identifies the fathers’ pathways into and experiences of homelessness, and the fathers share their stories of what it means to be a sole father. The paper identifies the issues fathers may experience when dealing with homelessness and fatherhood. An increased understanding of these experiences can contribute to the development of further research and improved practice with such families.     

Achieving Permanence in Foster Care for Young Children: A Comparison of Kinship and Non-Kinship Placements

ABSTRACT

A number of child welfare policies have reinforced the use of kinship care as the most preferred placement for foster children, reflecting the philosophy that maintaining children within their own extended family system contributes to their stability and well-being. Given the growing utilization and legislative emphasis on kinship care along with the push for an immediate implementation of permanency plans for children in foster care, this study examines how the permanency goal under the 1997 Adoption and Safe Families Act (ASFA) is being implemented and achieved. The reunification and permanency placement (adoption or legal guardianship) outcomes of children in relative and non-relative care are analyzed, focusing on the experiences of young children. Based on public child welfare agency data from 2000 to 2003, child, case, and placement variables are explored to identify which set of factors best explains case outcomes. The present study identifies the total length of foster placement (kinship and non-kinship), the length of family maintenance services, and the number of placement changes as the most important variables in determining family reunification and permanent placement (legal guardianship and adoption) outcomes for young children.     

A qualitative data analysis: family victim advocates in child advocacy centers

ABSTRACT

Family victim advocates in child advocacy centers provide a valuable resource to children and parents involved in child abuse investigations. This work requires that family victim advocates be knowledgeable in such areas as child development, crisis intervention, community resources, family relationships, child welfare and criminal justice systems. Because family victim advocates provide essential services to parents and caregivers, the role requires ongoing training and education to remain current on the ever-changing complexities of working with not only the children and families but also the criminal and child protection systems responsible for investigating these cases. The current study reports the findings from a nationwide survey of family victim advocates employed in child advocacy centers related to their motivation for doing the work as well as their perceptions of their training and potential training needs. A group of doctoral students comprised the research team and worked collaboratively under the supervision of university faculty to conduct the qualitative data analysis. The findings describe the characteristics and motivations of family victim advocates working in child advocacy centers and emphasize the need for more advanced trainings that focus on skill-building and strengths-based practices utilized to support children and parents in child abuse cases.     

Caseworkers' perspective on risk factors in the family environment influencing mothers' difficulties in meeting children's needs

ObjectivesThis study examines, from the caseworkers' point of view, which needs of children are the most difficult for parents in neglectful contexts to respond to and which risk factors make this response more difficult.MethodA sample of 55 parents being followed by child protection services for neglect or high risk of neglect accepted to participate in the study. Their caseworker filled out a grid regarding the response provided to the children's needs and the risk factors in the family environment.ResultsThe results indicate that the children's age is related to the difficulties of responding to their needs. The caseworkers are particularly concerned about guidance and boundaries provided to preschool-age children, but less so about that provided to school-age children. When the children's age is controlled for, parents' mental health problems explains a significant proportion of the variance in parents' response to their children's need for stimulation, emotional warmth, and guidance and boundaries. Caseworkers' worries about drug and alcohol misuse also explain a significant proportion of their concerns about the mothers' ability to ensure their child's safety.ConclusionCaseworkers are more worried about the parental response offered to preschool children than to school-age ones. However, a constant and coherent response to growing children is still important for their developmental trajectories. Moreover, mental health and substance abuse explain caseworkers' concerns about mothers' engagement toward their child. These data raise questions about which type of services to offer, because intervening in families where parents deal with personal issues while addressing child neglect is complex.     

Community Case Management Intervention for Hard-to-Place Homeless Families Leaving Emergency Shelter

Abstract

The Community Case Management Intervention was designed to fill a gap in services for hard to place homeless families who leave emergency shelters. There were 51 adults and 78 children who participated in the research. Families who met the criteria and volunteered for the study were randomly assigned to an intervention or comparison condition. Intensive case management was provided to families in the intervention condition upon their exit from the shelter. Services included referral, advocacy, support, and assistance with family problem-solving and decision-making. Comparison families did not receive similar services. Results of the study are encouraging and show that families in the intervention felt greater levels of social support and greater family unity.     

Wraparound Services: An Effective Intervention for Families Impacted by Severe Mental Illness

ABSTRACT

Children and families impacted by severe mental illness (SMI) have multiple strains that effect family functioning, child safety, and parental rights. Traditional services for children and families struggling with severe mental illness have not achieved success in improving family functioning and keeping families intact. Wraparound is a philosophy and a system of care with a promising evidence base that could enhance collaboration of child welfare, mental health, and community services to work more effectively with families impacted by SMI.     

Blue-Ribbon Babies and Labors of Love: Race,Class, and Gender in U.S. Adoption Practice by Christine Ward Gailey

ABSTRACT

We investigated the adjustment of differing sized adoptive families rearing children with developmental disabilities. Families of 5 or more children (large: n = 54) were compared with families of 4 or fewer children (conventional: n = 69) on a variety of demographic and outcome variables measuring family strengths, family disharmony, marital adjustment, and adjustment to the adopted child. Analyses of covariance on the outcome variables demonstrated that parents of large families were functioning as well or better than parents of conventional-sized families. We concluded that adoption placement practice should not exhibit bias against the placement of multiple children with developmental disabilities in the same family.     

Remaining home: Well-being outcomes and co-occurring parental substance use following a maltreatment investigation in middle childhood

PurposeThe purpose of the study is to understand differences in child well-being related to parental substance use among children ages 6–12 who were investigated for maltreatment but not removed from their homes. Children with a substance-using parent in the home are compared to those without a substance-using parent in the home.MethodsLongitudinal data from waves 1 and 3 of the second National Study of Child and Adolescent Well-Being (NSCAW II) are used. NSCAW II is a national sample of families with children and youth aged birth to 17.5 investigated by child protective services (CPS). A subset of the data (analyzed with domain analysis methods) is used for this study (n = 575). Eight well-being outcomes from four domains (cognitive development, physical health, psychological/behavioral development and social/emotional competence) are analyzed.FindingsWe hypothesized that (among children investigated for maltreatment and not removed from home) children whose parents used substances would exhibit lower mean levels of well-being at thirty-six months follow-up compared to those whose parents did not use. Unexpectedly, we found no significant differences in well-being levels between children with parents in the home using substances and those without.ConclusionsChildren with substance-using parents may be able to remain at home over an extended period after investigation, while maintaining well-being levels similar to children at home with parents not using substances. If an effective safety plan can be put in place, this option may provide a path to maintaining safety, permanency and well-being for such children without placement in out-of-home care.     

Genealogy and Ideology of Taiwan Homeless Delivery Services

Abstract

Since the mid-1990s, the number of homeless in Taiwan has been increasing. Politicians, policy makers, and service providers frequently debate whether the government should provide services for the homeless. Democracy and economic change have increased the number of homeless in Taiwan. However, the current homeless problem is also a product of a conservative welfare ideology based on family values and moral judgments. This study has implications for social workers and policy makers. (1) A universal principle for nationwide homeless delivery systems is required. (2) Restrictions that prohibit adults and youths with families providing little support from entering shelters should be eliminated. (3) Employment consultation and housing compensation should be provided to assist street people in re-entering mainstream society. (4) Supportive relationships with mainstream- based outreach services should be developed.     

Substance Abuse,Homelessness, Developmental Decision-Making and Spirituality: A Women's Health Issue

ABSTRACT

A qualitative methodology was used to examine the relationship between homeless women's spirituality, substance abuse, moral reasoning and developmental decision-making. Findings indicated that a lack of development in spirituality and the ability to make decisions in childhood is related to homeless, addicted women's inability to maintain abstinence and achieve social independence. Spirituality impacted decisions to abstain from substance abuse and increased the women's social independence. Findings suggest that treatment needs to incorporate spirituality, family of origin, and the development of skills for independent decision-making. The authors propose that childhood maltreatment, homelessness and substance abuse impede spiritual development. Therefore, substance abuse treatment needs to include a focus on spirituality and moral reasoning in the recovery process.     

A multi-dimensional assessment of the health needs of homeless infants and pre-school children in Phoenix

The dual purpose of this study was to identify the comprehensive health needs of a selected group of homeless children in Phoenix, Arizona, and to utilize the findings in developing needed services. A non-random sample of 60 infants and pre-school children were given on-site physical, dental, developmental, behavioral, and nutritional assessments. The study included Medicaid's Early Periodic Screening, Diagnosis, and Treatment procedures, complete oral screening, the Denver Developmental and Denver Articulation Screening Test, the Pre-school Behavior Inventory, and parental interviews. Fifty-eight of the 60 children screened needed further evaluation, treatment, or followup services. The most significant problems included low hematocrit readings, inadequate immunizations, and untreated medical and dental problems specific to this age group. Also identified were developmental delays and potential behavior problems. It is imperative that aggressive outreach and followup services be developed to reach homeless children and to insure that needed interventions are provided.     

Child development in HIV-positive and HIV-affected children in South Africa and Malawi—What role for community organisations?

There is evidence that children who are HIV positive (HIV +) are at risk for poor developmental outcomes. The aims of this study were to use developmental screening tools to measure outcomes of children affected by HIV/AIDS attending community-based organisations (CBO) and to determine what types of CBO provision these children were receiving. In a cross-sectional study, we interviewed 979 children and their carers (4 to 13 years) at 28 randomly selected CBOs funded by 11 major donors in South Africa and Malawi. Developmental outcomes were assessed using the Ten Questions childhood disability screening tool and the Strengths and Difficulties Questionnaire. Health-related quality of life was measured using the Paediatric Quality of Life Scale. Overall, 13.8% (n = 135) were HIV +. HIV + children were more likely to have developmental difficulties and lower health and educational quality of life, controlling for a range of factors. Developmental difficulties and poorer quality of life were predicted by being HIV +, living in South Africa, not attending school regularly, poor housing conditions and living with a sick family member. HIV + children tended to have been enrolled in CBO programmes for a longer period compared to other children but reported lower rates of contact. A greater proportion of HIV + children received medical services, psychosocial interventions and emotional support, compared to HIV − children. However, fewer HIV + children were enrolled in play groups, early childhood intervention programmes and educational programmes. Screening for developmental problems using short tools is possible in community settings in order to identify children with developmental difficulties and plan services for children infected with and affected by HIV. This study highlights the important role of CBOs to intervene to improve child development outcomes. The delivery of evidence-based services that target child development outcomes will enable HIV-infected children to meet their developmental potential and promote their participation in their communities.     

Houston Homeless Street Outreach

Abstract

Several cities in the nation have developed innovative programs to assist the homeless who are “living on their streets.” This paper describes one such program developed in Houston, Texas. The Homeless Street Outreach was a collaborative project of several service agencies in the greater Houston area. The outcome of this outreach project indicates that a coordinated effort can bring about delivery of more comprehensive services to the homeless population. The principles that emerge from the outreach include involvement of the homeless in planning and development, service agencies taking “ownership” of the project, and agency flexibility in delivering services to the homeless.     

The Importance of Adoption for Nurturing and Enhancing the Emotional and Intellectual Potential of Children

ABSTRACT

The present review examines whether the weight of the evidence indicates that adoption is, indeed, a benefit to the child. Several comparison groups have been used. In a number of studies, in United Kingdom, U.S.A. and India amongst others, a comparison has been made of the outcome of the child in his/her adoptive family to what it would have been had that child remained in her/his biological family, or in an institutional setting. Analyzing all the results, adopted children seem to function better than institutional children or children restored to their biological family.     

Contrasting perspectives of parents and service providers on respite care in Queensland,Australia

Abstract

Parent-carers need support to continue to care for their child with significant disability in their home. There has, however, been little evidence that respite interventions have consistent or enduring beneficial effects on carer well-being. This article reports the findings of a qualitative study which adopted an Appreciative Inquiry philosophy to interview parent-carers of children with significant intellectual and/or developmental disabilities on how formal support services have helped them maintain their health and well-being, and disability support staff on how they help such parent-carers foster their health and well-being. We conclude that better communication and collaboration between service providers and users, more targeted training of workers, and embracing a person-centred and family-centred approach to respite services are needed. In addition, clearer definition and communication of the scope of respite services are required to best support families of children with significant disability in their home.     

Creating a Family Centered Wellness Team: Lessons learned in creating an integrated continuum of care for families facing homelessness,addiction, and trauma recovery.

Abstract

Homelessness is often experienced by women and children, and recent evidence suggests that women and children are the fastest growing segments of the homeless population. Homelessness is often accompanied by mental illness, substance abuse, and histories of violence, for both women and their children. While trauma informed care has been incorporated into women's treatment systems there has not been widespread application of this knowledge to family centered work with homeless families. This paper explores the need for family strengthening approaches and identifies one model currently being evaluated that seeks to decrease service fragmentation, increase positive family interaction, and deepen the family's connections with each other and with the community.