‘It's afforded us a huge flexibility’: the impact of ‘Disabled Children's Access to Childcare Pilots’ on families with a disabled child in England

For many parents of disabled children, finding affordable and suitable childcare that meets their needs is very challenging. Research in the UK has shown that parents with disabled children experience barriers not just with cost, but also accessibility, the attitudes of childcare providers and in getting good information about sources of childcare. The Disabled Children's Access to Childcare (DCATCH) pilots was an initiative designed to improve access to childcare for disabled children in England. As part of an evaluation of DCATCH, qualitative interviews were carried out with 38 members of 22 families who had received support from the initiative. All of the families reported positive outcomes and highlighted: a beneficial impact on the parents' capacity to work; enjoyable experiences for the disabled child; increased confidence and independence for both parents and children; and the creation of time for parents to pursue other activities. The results of the DCATCH initiative support other research which argues that whilst cost is a significant factor around childcare choices for families with a disabled child, having confidence in the childcare provider's ability to meet specific needs (including complex health care needs) and providing positive experiences for the disabled child are also key, determining factors.     

A qualitative look at child care selection among rural welfare-to-work participants

The welfare reforms of 1996 changed the administration of public assistance to children and families. One of the key provisions, requiring parents to join the workforce, resulted in an expanded need for child care. Prior research demonstrates that welfare recipients, particularly in rural areas, utilize informal child care arrangements. Further, recipients in rural communities face greater challenges due to a lack of transportation, geographic spread, and less access to services. This qualitative study examined the child care selection experiences of 33 welfare recipients in six rural Northern California counties. More families selected home-based than center-based child care. During their search processes, welfare recipients utilized both formal and informal routes to locate child care providers. Parents took advantage of their connections with the social service system, but also accessed their social networks for recommendations. Rural families also reported that their choices were constrained by the available programs, transportation, and by the quality of the programs they were able to access. Given the high rate of utilization of home-based arrangements among families in welfare-to-work programs, quality of care in such programs should be improved. Recommendations for increasing quality and access, as well as supports for welfare to work participants, are discussed.     

“It's Really Not Easy to Get Help”: Services to Drought-Affected Families

Abstract

The present paper details the results of research conducted with drought-affected farm families in New South Wales (NSW), Australia. The study reveals the significant health and welfare stresses experienced by families and the lack of access to services and support. The research was conducted in three sites in rural and remote areas of NSW in 2003. Farm family members, service providers, and other community key informants were interviewed. The paper outlines ways that the social work profession can respond to significant natural disasters.     

Implementing the family preservation program: Feedback from focus groups with consumers and providers of services

There is a growing understanding that preventative child welfare efforts can be both more cost effective and are more desirable philosophically than strictly remedial programs. The Family Preservation Act provides funds to assist communities in strengthening and preserving at-risk families. In order to implement this program effectively, local communities must design new programs and procedures which will be both attractive to consumers and effective in meeting their needs. This study it identifies problems with contemporary child and family services and suggests solutions to those problems. This study uses a focus group format and presents ideas generated by those individuals who will be most directly affected by this legislation; front line service providers and service consumers. Several areas of weakness in the current service delivery system are identified, including bureaucratic barriers, limited resources, problematic consumer/provider relations and a range of collaborative issues, both within and between agencies and the communities they serve.     

The impacts of accessible child protection services on services, jobs, and families

This multi-faceted study assessed the differences between accessible and central child protection service delivery sites in Ontario on: (1) family functioning; (2) front-line child protection service providers' satisfaction with services; (3) parents' satisfaction with services; (4) the services and supports available to families; (5) front-line service job satisfaction; and (6) front-line helping relationships in child welfare. A quasi-experimental outcome design gathered data from parents at case-opening and approximately 10 months later. Semi-structured individual or group qualitative interviews were conducted with parents, front-line service providers, and supervisors/managers. Information also was gathered from agency files. Front-line service providers completed an employment questionnaire. Findings indicated that the accessible sites were able to foster a greater proportion of cooperative helping relationships with families and to create more service partnerships. Parents at the accessible sites were more positive about their service involvements and more willing to ask for help again in the future. Front-line child protection service providers at both service delivery models described positive aspects of their jobs as well as frustrations with the expectations of the formal child protection system.     

Infant–Mother and Infant–Caregiver Emotional Relationships: Process Analyses of Interactions in Three Contemporary Childcare Arrangements

Emotional relationships in infant–mother dyads in families where mothers provided full‐time childcare were compared with those of families where mothers used in‐home childcare providers and family childcare providers (N = 245). Infant relationships with childcare providers were also studied. Emotional relationships were adequate in all three childcare arrangements, but infant–mother dyads in in‐home childcare arrangements displayed healthier emotional relationships than infant–mother dyads in mother care arrangements; no differences in the health of emotional relationships with infants emerged among the three types of childcare providers (mother care, in‐home childcare, family childcare). Infant–mother dyads in in‐home childcare arrangements also displayed healthier emotional relationships than infant–in‐home childcare caregiver dyads, but infant–mother and infant–caregiver dyads were comparable in family childcare families. Emotional relationships in infant–mother and infant–caregiver dyads were not correlated, regardless of the type of childcare.     

Mental Health Consumer and Carer Participation in Professional Education: ‘Getting There Together’ for Children of Parents with Mental Illness and Their Families

Abstract

‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘… the whole family, and how the child fits into the picture’.     

Youth outside the labour force — Perceived barriers by service providers and service users: A mixed method approach

BackgroundYoung people who are neither in employment nor in education or training (NEET) have received increasing attention in Western countries. While some young people in the labour force are unemployed because of a shortage of jobs, others would be without employment even in periods of economic growth, when more jobs are available. The latter group is referred to as neither in the labour force nor in education or training (NLFET), and such people need intervention to improve their chances of work participation. However, this group is poorly understood, and more knowledge is needed to develop efficient measures. The purpose of the study is to investigate the NLFET population and to identify barriers to education or employment.MethodInterviews were conducted at all labour and welfare offices in a representative county in Norway, and an internet-based survey among 586 persons aged 18–29 years who met the NLFET criteria was conducted. Sixty case managers of young service users and 30 managers/assistant managers were interviewed at the 25 offices in the county.ResultsThe local labour and welfare offices prioritize young clients, and some have designated follow-up teams for young service users. Three main barriers to education or employment were identified through the interviews at the offices: client motivation, the sense of lack of achievement/defeat, and unrealistic expectations about working life. A survey of the young people revealed other barriers, such as health problems (60%), low education (55%), lack of work experience (41%), the feeling of being exhausted (38%), low self-esteem (36%), feeling depressed (35%), sleeping problems (35%), and very often a combination of these barriers.ConclusionsHealth problems, social and other problems are highly prevalent among the NLFET population. The majority of the population wanted to find a job or to complete their education. We conclude that mental health problems often camouflage social problems. Treatment of complex problems should not be left to mental health services. Given the nature of the barriers identified, follow-up by strong multi-professional teams, including social work and health professions, should be part of the measures allocated to the NLFET population.     

Deconstructing Family Time: From Ideology to Lived Experience

“Family time” is often uncritically accepted as a uniform, coherent concept and a universally desirable goal. In order to fully understand the meaning of family time in experience, interviews were conducted with parents in 17 dual‐earner and 11 single‐parent families, and 8 observation episodes were done with 4‐ and 5‐year‐old children in childcare. What emerged was a dramatic discordance between the expectations and experiences of family time. Although families have held on to an expectation of a positive experience of togetherness, they are typically left with a feeling that there is never enough, that it is in the service of children, and that they are duty‐bound by it. There is a structural contradiction between the ideals and experience of family time that is typically expressed through disillusionment and guilt.     

Family and Friends as Respite Providers

Abstract

Consumer-directed service options in home- and community-based care are increasingly available to adults with chronic conditions and cognitive impairments and to their family caregivers. Few studies, however, examine the experience of family caregivers who, when given a choice of providers of respite assistance (i.e., relief from the stress of providing constant care), prefer to hire family or friends rather than service providers. This study describes the in-home respite experience of family caregivers served by California's Caregiver Resource Centers “direct-pay” program who hire family or friends (n = 39) or service providers (n = 77) to provide in-home respite assistance. Findings revealed similarities between the two groups with few exceptions: caregivers who hired family or friends reported poorer physical health, were slightly more satisfied with the respite assistance, and received more hours of respite at a lower unit cost. These findings lend support to consumer-directed respite service options where family caregivers are given flexible alternatives that may act to remove barriers to respite service availability and use.     

AsianWORKs

ABSTRACT

Achieving economic self-sufficiency through employment is the ultimate goal of recent changes to the welfare program. The Asian American and Pacific Islander (AAPI) population is most vulnerable to failing in this goal because of language difficulty, low education levels and lack of job skills in the labor market. Many AAPI immigrants, and Southeast Asian Americans in particular, suffer from adjustment and mental health problems due to their experiences as refugees. These are but a few of the obstacles for AAPI welfare recipients to become self-sufficient, making them one of the most “hard-to-serve” populations. The goal of self-sufficiency through employment can be reached if culturally appropriate and adequate support services are provided to meet the unique needs of the population. Few programs, however, are targeted at AAPIs. Using key-informant interviews and the case material review method, this article highlights the difficulties of AAPI welfare recipients and describes a unique program serving the Southeast Asian American, particularly the Cambodian, population. The article focuses on the program components of outreach and engagement, day socialization and job readiness, and family support services, and it discusses improvement to service access and lessons learned for the practice of cultural competence.     

Implications of Welfare Reform on the Elderly

Abstract

Whereas many studies of welfare reform have focused on effects on children and families, little research has examined the implications of welfare reform for the elderly. This case study incorporates interviews with service providers for the aging, members of advocacy organizations, and two focus groups of older consumers conducted in the multi-ethnic urban community of San Francisco. Study findings suggest that welfare reform has had both direct and indirect effects on the elderly and their services in the study community. Direct effects derive primarily from changes in the welfare reform legislation that had the effect of undermining both immigrants' eligibility for and claiming of public assistance benefits. Indirect effects on older persons include increased child-care demands upon grandparents. The case study data bear on a significant policy change within the broader trend of devolution at a historical point when anti-immigrant sentiment in the United States was running high.     

Minimizing Vulnerability: Selective Interdependencies After Welfare Reform

The issue of dependency permeates the American welfare discourse. Although most of the 50 low-income women we interviewed in our research echoed the distain of dependency found in the broader welfare discourse, they overwhelmingly described actively cultivating some forms of interdependence. For example, many of the women used state childcare vouchers to channel resources into their family networks while simultaneously adhering to an ethic of family care for children. They found this reliance on state resources and family to be desirable—and in fact a sign of “independence”—because it enhanced the economic security of their families while preserving the physical and emotional safety of their children. In contrast, the women tended to view reliance on men as undesirable—a form of “dependence”—because it did not enhance their perceptions of security. Thus while the women talked about becoming independent, in fact they cultivated selective interdependencies to minimize their economic, emotional and physical vulnerability. Independence for our respondents was not a lack of reliance on others but rather the ability to provide safety and security for themselves and their children. Our analysis may sheds some light on why welfare reform efforts aimed at increasing marriage rates have been less successful than those aimed at increasing employment rates.     

Paid personal assistance services:an exploratory study of working-age consumers' perspectives

This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.     

Maternal Functioning, Time, and Money: The World of Work and Welfare

Numerous studies have assessed families' employment and financial stability following welfare reform. Yet little research has addressed whether welfare and work transitions are linked with other changes in family functioning. Using a representative sample of approximately 2,000 low-income urban families from the Three-City Study, analyses assessed whether mothers' welfare and employment experiences over a two-year period following welfare reform were related to changes in family well-being. Lagged regression models controlling for family characteristics and earlier levels of functioning found that moving into employment and stable employment (of 30 hours or more per week) were linked to substantial increases in income and improvements in mothers' psychological well-being. Movements into employment also were associated with declines in financial strain and food insecurity. Sustained or initiated welfare receipt was related to relative declines in income, physical health, and psychological well-being, but also to improved access to medical care. In contrast, mothers' welfare and work experiences showed very limited relations to changes in the quality of parenting or of children's home environments. These patterns were similar for families with young children and those with adolescent children. Results suggest that parenting behaviors are more resistant to change than are maternal emotional and economic functioning.     

A Social-Epidemiological Five Year Cohort Study of Homeless Families

Summary

There are significant social investments in families uprooted by homelessness. There are no data clearly delineating types of families helped, and how long help has sustained them. Computer technology was utilized to track eight hundred and seventy-five homeless families who received networked services from both public and private providers in a case managed family shelter from 1983 to 1987. Discussed are secondary data in case files and primary data from field interviews on longitudinal residential history, employment, familial and demographic changes, and service needs.

Policy questions focus on current residential stability and community reintegration.     

Engaging with Disability Services: Experiences of Families from Chinese Backgrounds in Sydney

People from Chinese backgrounds remain underrepresented in disability service use. This paper explores family experiences of using child disability support services to understand how migration and their cultural expectations about disability and service affect the way they use services. Qualitative semistructured interviews were conducted with 13 family carers in Sydney. They were striving to gain good support for their child from formal services. However, most of them were reluctant to express any dissatisfaction to service providers, which meant that assertively requesting different support was difficult and culturally inappropriate. In response, service providers can design nonconfrontational ways to elicit this vital information and support families to gain experience tackling conflict.     

Necessary Steps in Designing a Successful Contract

Abstract

Parents with a history of serious mental illness are vulnerable in many ways and are therefore likely to be accessing services from a range of government and community agencies. The use of multiple services, sometimes with conflicting practice frameworks, can result in sub-optimal management of these families. This study surveyed 77 service providers from a range of government and non-government agencies targeting their views regarding parents with a serious mental illness (specified in this study as schizophrenia, bipolar disorder and psychotic depression). They were asked what they perceived were difficulties for this population, interventions required to meet the needs of this group and finally, barriers to effective service delivery. We found that service providers reported that current services were inadequate for these parents. Parent-based interventions were seen as being more beneficial than those targeting children. Lack of liaison between agencies and lack of coordinated service provision were seen as the greatest barrier to effective service delivery. The results highlight the need for policy planners and service providers to develop strategies to ensure effective coordination between services that work with this population.     

Military spouses speak up: A qualitative study of military and Veteran spouses’ perspectives

ABSTRACT

The purpose of this qualitative study was to examine military family life through the lens of military and Veteran spouses. Twenty-two female, active-duty military and Veteran spouses provided extensive written responses to essay questions as part of an online survey that were analyzed with qualitative data analysis methods. Findings revealed seven main themes: how military life has influenced health care access, spouses’ identities as caregivers, marital relationships, health outcomes, social support, spouses’ educational and career opportunities, as well as their personal growth. In summary, their experiences indicate that military service affects all aspects of their lives. Spouses gave numerous suggestions as to how service providers can address their unique experiences to improve the supports they offer military families, including ensuring the spouse is involved in health care, and providing support programs that focus on the entire family.