Kinship care and service utilization: A review of predisposing,enabling, and need factors

Research has shown that relative caregivers are less likely to use formal supports and services than non-relative foster parents. However, less is known about factors influencing kinship caregivers' help-seeking behaviors and service use. This systematic review identified research studies examining factors associated with service use among kinship caregivers using key search terms in five computerized bibliographic databases and four journals. The search identified 337 potentially relevant studies. After screening and study eligibility assessments, a final sample of 13 studies was reviewed. Findings suggested that although children and their kinship caregivers were clearly in need of services, service use was low. Results suggested a need for more rigorous research designs and that the following factors may influence service use: child behavioral problems, caregiver mental health status, resources, provider characteristics, caregiver perceived need, and social support. More research examining help-seeking behaviors, perceptions of formal services, and effectiveness of kinship caregiver services in relation to child outcomes is needed to improve the wellbeing of kinship families in the child welfare system.     

Challenging implicit bias: preparing students to practice with African American families

ABSTRACT

The disparity of African American families in the foster care system is a concern in the field of child welfare services and the social work profession. African American families experience unique challenges related to discriminatory practices and implicit biases in the child welfare system and by mandated reporters. To address these inequalities, state and local agencies have implemented prevention and intervention services to support minority families. Additionally, child welfare agencies have invested in professional development training for their workers to alleviate possible intolerant practices. This article describes implicit biases and considers how they could contribute to the disparity of African American families involved in the child welfare system. Furthermore, the article presents approaches to help social work students to identify and challenge their implicit biases to support culturally sensitive practices while working with African American families. It concludes with implications for social work education.     

A case study of an African American stepgrandmother raising adopted grandchildren

Research on the perspectives of older African American stepgrandparents raising adolescent grandchildren is underdeveloped. This case study research uses a culturally sensitive conceptual framework to explore the experiences of one African American stepgrandmother raising adopted grandchildren. The participant was identified in a larger study of older grandparents raising adolescent grandchildren. An in-depth, face-to-face interview was conducted in a public place. The themes described by this older African stepgrandmother included (1) strong family ties overlaid with family conflict and emotional difficulties, (2) traditional philosophies of parenting and childrearing that conflicted with her spouse, (3) reliance on a constellation of support including her religious community, and (4) recommendations for improving resource development. The findings of this case study identify critical issues for this older African American stepgrandmother. Although the findings are not meant to generalize, social workers and other helping professionals can benefit from the increased knowledge gained from this stepgrandmother’s experiences that can inform issues for exploration with similar caregivers.     

The last mile of the way: understanding caregiving in African American families at the end-of-life

This research is based on in-depth ethnographic interviews and focus groups with 88 African American family caregivers from various regions of the United States during a stressful time in their family development--caregiving at the end-of-life--and the grieving during the aftermath. The study employed a stratified purposeful sampling strategy. Subjects were African Americans from the Northern, Southern, and Midwestern United States. Formal care is complicated by the distrust that many African Americans hold toward the health care system, which has resulted from years of exclusion, racism and discrimination. The findings highlight the importance of hearing from African American families to gain an understanding of what services, including family therapy and other psychotherapy, they will need during this process.     

African American Men,Child Welfare,and Permanency Planning

Summary

Like social services generally, child welfare and permanency planning services have failed to incorporate African American men as significant and serious participants in the service delivery process. Child welfare and permanency planning services have marginalized African American men such that children fail to benefit from the inclusion of these men in the service delivery process. This incomplete and inappropriate approach to permanency planning specifically, and to child welfare services more generally, is a disservice to African American children. Corrective measures are proffered to promote greater inclusion of African American men in child welfare and permanency planning services.     

Racial and Ethnic Differences in Family Caregiving in California

Abstract

Family caregivers are the main source of long-term care for older persons in the United States. At the same time, cultural values and beliefs shape decisions surrounding who provides care and whether families use formal support interventions to assist the caregiver. The current article examines how the family caregiving experience differs among racial and ethnic groups in terms of caregiver characteristics, service utilization, caregiver strain, and coping mechanisms. Telephone interviews were conducted in English and Spanish with a random sample of 1,643 respondents in California who provide care to someone age 50 or over. Bivariate analyses showed evidence of ethnic differences in the demographic characteristics of caregivers, intensity of care provided, caregiver health, level of financial strain, religious service attendance, formal service utilization and barriers to formal services. Odds ratios showed that White and African American caregivers were about two times as likely to use formal caregiver services as were Asian/Native Hawaiian/Pacific Islander and Latina American caregivers. Implied by these findings is the need for further understanding of caregiver service needs among diverse racial and ethnic groups.     

Relationship Separation and Help-seeking: Reporting on an Agency Study

Relationship separation affects many Australians with around 20,000 divorces involving children formalised per year. For profit, government and nongovernment organisations all offer services for separated couples and families. Despite promotion of specialist services such as mediation and child-centred services, which seek to assist families to navigate what is a complex interaction between public and legislative structures, there is little known about the potentially broader array of supports and information people use following separation. Better understanding of help-seeking behaviours for separating couples enables more effective targeted policy and service delivery. Individuals with children accessing a nongovernment-funded program for support during separation (n?=?134) were asked to complete a survey that was designed to track their help-seeking behaviour. We found that help-seeking for legal services was more common than seeking help for self-care, but that both were important for many people in the sample. Friendship networks, and medical and health professionals were the most common sources of information and support. We argue that social work has a role in promoting and supporting parents who are separating to access a broader range of informal support networks and professional services.     

Social Relationships of African American and Hispanic Older Assisted Living Residents: Exploring the Role of Race and Ethnicity

African American and Hispanic older adults are underrepresented in assisted living communities, so little is known about how they experience social relationships in these settings. The purpose of the study was to explore resident-to-resident and resident-to-staff relationships experienced and perceived by African American and Hispanic older residents in assisted living settings. In-depth interviews with 15 African American and 15 Hispanic older adults were conducted in seven assisted living communities in Central Florida. Three salient themes emerged using a grounded theory approach: formation of relationships: emotional vs. instrumental support; language as a facilitator or barrier; and avoidance of inter-racial relationships. Implications for providing culturally competent services in assisted living communities with diverse populations are discussed.     

Citizenship Social Work: A Community Environmental Scan of Re-enfranchisement Social Work Supports after Felony Conviction

Alexander (2012) argues that the corrections system relegates African American men to permanent second class status. Although social work has advanced the democratic project, African Americans often have had to forge a parallel social assistance system. In a community environmental scan, the authors apply the Citizenship Social Work framework to assess availability of services, supports, and advocacy efforts to address civil, political, social and economic rights for African American men with felony convictions. The authors find that a number of social work services are available, but the majority focus on social and economic rights, rather than civil and political rights, perhaps emphasizing professional service over social justice.     

The Social Environmental Elements of Resilience Among Vulnerable African American/Black Men Who Have Sex With Men

Resilience theory has been suggested as a strong framework for research on HIV prevention among men who have sex with men (MSM). Among this population, literature indicates that African American/Black MSM are particularly vulnerable to health and social disparities associated with HIV transmission risk. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates the specific elements of resilience, and the associated contexts and relationships, among a sample of 21 substance-using African American/Black MSM. Data indicate that (1) elements contributing to resilience are multiple and co-occurring, including inner strengths, social relationships, diversity of experience, religion/spirituality, altruism, and creativity; (2) as an element of resilience, social support was experienced differently among men who did and did not have supportive relationships with other gay and bisexual men, which has implications for social service provision and intervention approaches; and (3) diversity of experiences and relationships is an important influencing factor on expressions of resilience. Social services or interventions that facilitate the development of these elements of resilience will likely be especially beneficial for vulnerable African American/Black MSM.     

African American Informal Support Networks

Abstract

This study examined African American informal support network functioning utilizing Vaux's (1998) reciprocal exchange model. Ten African American caregivers of relatives with severe mental illness and their main informal helpers were interviewed using a semi-structured questionnaire. In 8 of the 10 African American families interviewed, one close relative, called a “main supporter,” assumed major responsibility, comparable to that of the primary caregiver, for care and supervision of the family member with mental illness. Main supporters felt that their family helper role, although stressful at times, gave meaning and purpose to their lives. Five main supporter-primary caregiver pairs formed 'joint households' to share economic and human resources and to facilitate caregiving duties. Social work intervention for caregiving families should provide assistance to both primary caregivers and their informal supporters, particularly main supporters.     

Differentiating Characteristics and Needs of Minority Grandparent Caregivers

Abstract

Data collected over a three-year period compared two groups of African American grandparent caregivers with a group of European American grandparents who were raising their grandchildren. Gender, marital status, and household income differentiated minority from nonminority participants. Statistically significant differences among certain of the demographic variables between the two groups of African American grandparents were also found. Practical implications of the results for research and practice are discussed through illustrating differences in advocacy needs and agenda-making between two grandparent caregiver support groups.     

A Culture of Mutual Support: The Impact of Giving and Receiving of Practical and Emotional Support on African American Marital Satisfaction

Although the literature has discussed the extensive family network ties of African Americans and its implications for marital satisfaction, few studies incorporate primarily African American samples in studies of marital satisfaction and social networks. This study draws on a sample of African American married couples from the National Survey of American Life and explores the impact of mutual support, giving and receiving of practical and emotional support, on the marital satisfaction of husbands and wives. Results from the ordinal logistic regression analyses reveal that emotional support received from family and support given to friends are significantly related to husbands’ marital satisfaction whereas emotional support received from family and negative interaction with family contributes to wives’ marital satisfaction. Research and practice implications with African American married couples are discussed.     

Informal caregiving for elders in Sweden: an analysis of current policy developments

In Sweden, care of elderly people is a public responsibility. There are comprehensive public policies and programs providing health care, social services, pensions, and other forms of social insurance. Even so, families are still the major providers of care for older people. In the 1990s, the family was "rediscovered" regarding eldercare in Sweden. New policies and legislative changes were promoted to support family caregivers. The development of services and support for caregivers at the municipal level has been stimulated through the use of national grants. As a result, family caregivers have received more recognition and are now more visible. However, the "Swedish model" of publicly financed services and universal care has difficulty addressing caregivers. Reductions in institutional care and cutbacks in public services have had negative repercussions for caregivers and may explain why research shows that family caregiving is expanding. At the same time, a growing "caregivers movement" is lobbying local and national governments to provide more easily accessible, flexible, and tailored support. In 2009, the Swedish Parliament passed a new law that states: "Municipalities are obliged to offer support to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities." The question is whether the new legislation represents a paradigm shift from a welfare system focused on the individual to a more family-oriented system. If so, what are the driving forces, motives, and consequences of this development for the different stakeholders? This will be the starting point for a policy analysis of current developments in family caregiving of elderly people in Sweden.     

The ecology of social support in relation to academic and behavioral self-perceptions among African American boys and girls

ABSTRACT

In this research, the ecology of perceived social support was examined across multiple contexts (i.e., parents, teachers, classmates, and close friends) in relation to self-perception indices among African American school-age children. Social support is multifaceted and includes positive regard from others, practical support, and stability of care. While there is ample evidence that levels of perceived social support are predictive of self-perceptions, there is less information regarding ecologies of social support. African American children are subject to disparate discipline in schools which can create discontinuity in social support across home and school. Furthermore, research has suggested African American boys and girls have different experiences and expectations across parent, school, and peer contexts. Hence, the question arises as to what ecologies of social support are more or less impactful, and for whom? Cluster and canonical correlation analyses were employed to identify and create relevant ecologies across adult and peer social support items. The results suggested the following: a) continuous positive social support was associated with enhanced self-perceptions, b) some patterns of discontinuity were particularly germane for self-perceptions, and c) relations between perceived social support and self-perceptions outcomes varied by gender. Practical implications are discussed.     

Facilitating Mental Health Service Use for Caregivers: Referral Strategies among Child Welfare Caseworkers

Unmet needs for mental health care are common among caregivers involved in the child welfare system. Although child welfare caseworkers are well positioned to identify service needs and refer caregivers to treatment, little is known about the types of referral strategies used in practice, or their effectiveness for promoting mental health service use. The current study examined child welfare caseworkers' use of different referral strategies and the extent to which these strategies are associated with caregivers' receipt of mental health services within a national sample of child welfare cases. Analyses of the second cohort of families from the National Survey of Child and Adolescent Well-Being suggest that child welfare workers more often use informational strategies for referring caregivers, including suggesting treatment or providing information about treatment options. However, social referral strategies such as providing caregivers with direct assistance in completing applications and making and attending appointments were associated with a greater likelihood of caregivers receiving mental health services. Findings support evidence from other service contexts that service use is facilitated by caseworkers' direct support for arranging services. Implications for research and for child welfare managers and administrators are discussed.     

Cultural Diversity and Help-Seeking Behavior

Summary

Four hundred ninety-four parents were surveyed to determine their attitudes about parenting, help-seeking behavior, and obstacles to accessing help with parenting. Comparisons were made with regard to race/elhnicity, gender, and education to determine what attitudinal similarities and differences exist. Most parents identified family members and friends, as well as print and video materials as important sources of help. Parents were less likely to use social service agencies, teachers, doctors and clergy. The likelihood of attending parenting classes was strongly associated with gender and education. High school graduates were more likely than non-graduates to use parenting classes and mothers were more likely than fathers to use parenting classes. African American parents were less likely than other groups to use print and video materials and African American and Hispanic/Latino parents were less likely to seek help from friends.