Working with neglected children and their families

Child neglect has proved a particularly difficult area for social work to address. In the first part of the paper a number of reasons for this are discussed. We go on to suggest that chronic child neglect characteristically involves the breakdown or absence of a relationship of care. Therefore, the social work response needs to include a focus on the relationship difficulties between parent and child which manifest as either an unwillingness or inability on the part of the primary carer to offer reliable, adequate care, and on broader relationship difficulties within the family. In arguing for an approach that pays attention to the intra-personal and relational dynamics of neglect, we draw specifically on attachment theory and consider how Ainsworth's (1978) typology of attachment patterns can shed light on parenting styles and patterns of family functioning associated with chronic neglect. We use the concept of the 'internal working model' to develop an understanding of the ways in which family members understand and live out their relationships—with each other and with the worker. We conclude by suggesting that this relational approach requires an ability on the part of the social worker to work both with and within relationships, and look at the contribution that a critically informed relationship-based approach can make to work with families where child neglect occurs.     

The rediscovery of child neglect

The article is a discussion of the construction of child neglect in a child and family social work team in the UK, based on ethnographic research in the social work office. Two influential and contrasting professional discourses on neglect are identified, and it is suggested that the dominant construction of neglect in the team studied is maternal failure to adequately service children's bodies. This construction is discussed in relation to some relevant theoretical insights and in the context of trends in contemporary child protection work.     

Social work intervention with Bedouin-Arab children in the context of blood vengeance.

Blood vengeance is a culturally specific phenomenon that can place Bedouin-Arab children at high risk of neglect. This case study examines the psychological and social implications of vengeance on children, the children's coping strategies, and the role of social work. The social work function includes nonauthoritarianism, strategies for forming a positive helping alliance, and various forms of culturally sensitive assessment and intervention. The study therefore yields insight into bridging the emic-etic gap in conceptualizing and responding to child neglect in a non-Western society.     

The prevalence and nature of abuse and neglect in children under four: a national survey

This paper reports the results from a Danish national survey of child abuse and neglect. Data were obtained by a written questionnaire sent to all home health visitors. All newborn Danish children receive visits by a home health visitor several times during their first year of life. For children in need of special care for social reasons the visits may continue until school age (at 6 or 7 years). The questionnaire included four checklists of signs of abuse and neglect. The home health visitors were asked to record what they had actually observed visiting the children in their homes. Eighty‐three per cent (covering about 80% of all newborns) answered the questionnaire. The objective was to establish a scientific based framework that could be used to guide preventive efforts. Ten per cent of all children under 1 year of age may be characterized as children in need of special care for social reasons, the most frequent single reason being reliance on social assistance, alcohol abuse or violence against the mother. A minimum of 4% of infants are subjected to broadly defined abuse or neglect from one or more of the four categories: physical abuse, physical neglect, emotional abuse and emotional neglect, physical and emotional neglect being the most frequent and physical maltreatment the most rare. Copyright © 1999 John Wiley & Sons, Ltd.     

How Do Social Workers Respond to Potential Child Neglect?

Although neglect is a common form of child maltreatment, it can be difficult to detect within a clinical interview between a social work clinician and client for the purpose of assessment and intervention, leading to a failure to act and secure a child's safety. This Canadian study utilized the objective structured clinical exam (OSCE) to assess social work clinicians' ability to recognize and respond to a case of suspected child neglect. Twenty-three participants (social work students, recent graduates of a Masters in Social Work programme, and experienced social workers) conducted a 15-minute interview with a standardized client followed by a structured reflective dialogue focusing on case conceptualization and emotional awareness. Qualitative analysis of the reflective dialogues revealed participants' difficulty in detecting child neglect as opposed to focusing on a client's negative self-beliefs or mental health issues. Implications for social work education and practice are suggested.     

Social Workers’ Preparation for Child Protection: Revisiting the Question of Specialisation

Abstract

Child welfare work is a key field of practice for social work graduates and for graduates of a growing range of disciplines. In the present paper, the authors drew on a survey of 208 child welfare workers and interviews with 28 senior personnel in child and family welfare agencies to analyse perceptions of the educational preparation of social workers and other human science graduates for this field of practice. The findings indicated that child welfare workers and employers are ambivalent about the value of social work and other generic social science and human services programmes as preparation for tertiary or statutory child protection practice, which involves investigation, assessment, and intervention in child abuse and neglect. The authors argue that the social work profession must better balance generic and specialist aspects to prepare graduates for practice in specialist fields of high social work involvement, particularly in tertiary child protection work.     

Children at risk: rationales for risk assessments and interventions

In this study, we examine and compare the rationales that social workers and laypersons give for their judgments, assessments and decisions in cases of alleged child abuse and neglect. We have used Toulmin's framework to explore the structure of the arguments/rationales of social workers and laypersons. We analyzed separately basic and complementary level arguments. We used Rosen's work to analyze the content of the backing provided by respondents for their claims.We presented two groups of respondents—52 social workers and 50 laypersons—with a case vignette that was a referral of a child and family made by a family physician. Respondents were asked to read the case, provide their assessment of risk to the child, recommend an intervention, and give written and detailed rationales for their assessment and recommended intervention.The findings indicate that social workers and laypersons differ in the structure and in the content of their rationales. Social workers formulated significantly more complete arguments, both basic and complementary levels of arguments, than laypersons. The content of the backing for the judgments was also significantly different: Social workers used more theory, experience and policy than the laypersons who used more general knowledge and values.In the discussion, we address the training implications of the fact that social workers pay very little attention to rebuttal of arguments, and do not refer to research evidence as a basis for the arguments they make. We recommend that more research focus on arguments and rationales given by professionals in this area.     

Reporting Suspected Child Maltreatment: Educating Social Work Students in Decision Making and Maintaining the Relationship

ABSTRACT

As future mandated reporters, social work students face the dual challenge of rendering accurate reporting decisions while concurrently maintaining the therapeutic relationship in an effort to decrease future child abuse and neglect. To address the paucity of training in this regard, 42 bachelor of social work (n=18) and master of social work (n=24) students participated in a workshop focused on decision making and the therapeutic relationship in mandatory reporting of child abuse and neglect. Participants were given a case vignette and responded in writing to structured questions. Two patterns emerged from the qualitative analysis: factors that centered on the case and those that centered on the social worker. Implications for social work education are suggested.     

Social profile,maternal depression and welfare concerns in clients of health visitors and social workers: a comparative study

Research into the practice of health visitors and child care social workers with depressed mothers is limited. This is surprising in view of the known relationship between motherhood and depression, and the association also between child care problems and maternal depression. The study described below is the first which seeks to compare health visitor and child care social work clients/service users in relation to the issue of maternal depression. In particular, it seeks to compare the extent to which maternal depression is a feature of the work of social workers and health visitors, the relationship between maternal depression and the social composition of different client groups, the relationship between maternal depression and welfare concerns—particularly child abuse—and the extent to which such concerns lead to referral from health visitors to social workers. The research shows: (1) interesting similarities between the depressed health visitor clients and social work clients as a whole; (2) the importance of low income and absence of support in the ‘progression’ from health visitor to social work clients status; and (3) an alarming emerging gap in services provided for severely disadvantaged families with child and family care problems.     

Child care burden and the risk of child maltreatment among low-income working families

Studies suggest that a substantial proportion of low-income working mothers experience work disruptions and parental stress related to child care, which may lead to increases in the risk of physical and psychological abuse and neglect of children. However, little research has examined the relationship between child care burden and the risk of child maltreatment among low-income working families. Using the Fragile Families and Child Wellbeing Study 3-year data, this study explores how child care burden is associated with the risk of child maltreatment (physical aggression, psychological aggression, and neglectful behavior) among low-income working mothers. We find that instability in child care arrangements is likely to increase mothers' physical and psychological aggression, while not having someone reliable for emergency child care is likely to increase mothers' neglectful behaviors. Findings also show that the risk of child maltreatment related to child care burden measures is more significant for single mothers than married mothers. Potential policy implications are discussed.     

ASSESSING THE NEEDS OF TRAUMATIZED CHILDREN TO IMPROVE OUTCOMES

This paper is about the development of an outcomes‐based treatment approach in work with traumatized children and of an assessment model to measure progress. In particular, it shows how a spider diagram is used to give a powerful, visual representation of a child's progress. The work described has been carried out by SACCS — an independent UK organization providing treatment based in residential and family settings for children who are severely traumatized by abuse and neglect. This trauma has had a massive impact on their development socially, physically, emotionally, academically and spiritually. The children have complex needs which are extremely difficult to work with. However, the potential for recovery from their injuries remains. I will use a single case study of a child to illustrate the process of assessment and measurement of recovery. The treatment approach used is broadly psychodynamic. The concept of an outcomes‐based approach and the measurement tool described also has widespread relevance in social care.     

The context of decision-making in cases of child neglect

This paper explores professional decision-making in cases of child neglect within the context of child protection practice in Britain. The literature on the nature of neglect is reviewed. Difficulties associated with decision-making are then examined within a framework that addresses the social, political and organizational context of child protection practice. It is argued that the current system, which focuses on incidents of abuse rather than the context of children's lives, provides inadequate protection for many children experiencing chronic neglect. Conclusions are drawn with regard to the development of practice that supports vulnerable parents while still remaining the child's welfare as paramount. © 1998 John Wiley & Sons, Ltd.     

Spirituality and Social Care

In this paper I discuss the main theoretical ideas in the book and the way in which the author applies them to social casework. I consider the relevance of these ideas to contemporary social work in terms of their contribution to the knowledge base of social work and social work methods. I argue that Kleinian ideas can make an important contribution to understanding the interpsychic and intrapsychic aspects of human experience with which social workers come into contact. I suggest that the author writes about the casework relationship with little regard to the social and political contexts in which social work is undertaken and that in contemporary social work, there needs to be a relationship between three different elements, namely: the client--as an individual within their social context; the emotional dynamics of the client-worker relationship; and the integration of theory, social policy and the legal framework.     

Community perceptions and foster care placement: A multi-level analysis

Signs of physical and social disorder in a community have the potential to influence the perceptions about community, which could, in turn, impact the decision making processes involved in child maltreatment investigations. While extant research has demonstrated a link between community context and child maltreatment rates, there is a dearth of research examining the potential relationship between social conditions in a community and the child welfare system's response to allegations of neglect. This study examined the relationship between child- and community-level characteristics and the decision to place a child in foster care. Two data sets were linked, one containing detailed observations of community conditions (e.g., cigarette and alcohol advertisements) and a second with individual child level information about child welfare investigations. Multilevel models allowed for the simultaneous understanding of child- and community-level characteristics. The results indicated strong associations between individual characteristics and foster care placement. The race or ethnicity of the child was a strong predictor of entry into foster care, and young children were much more likely to be placed in foster care than older children. Furthermore, community factors were also associated with placement into foster care. Specifically, the presence of litter and graffiti and the lack of security signage in a neighborhood appeared to impact the decision making process for foster care.     

Between love and behaviour management: the psychodynamic reflective milieu at the Mulberry Bush School

ABSTRACT

This article presents findings from a qualitative research study of the Mulberry Bush School (MBS), a therapeutic residential primary school caring for children with severe social, emotional and behavioural difficulties. The article notes the challenges of working with children who have experienced traumatic relationship breakdown, and reviews ideas and practices developed at MBS to support the children’s development. There is a discussion of the research study’s methodology and main findings. The researchers argue that the therapeutic milieu at MBS maintains a creative tension between a secure, playful context and one where emotional disorder and disturbance are not suppressed. The study describes how a particular psychodynamic model of reflective practice has been successfully instituted at MBS to create a ‘staff therapeutic milieu’ supporting the group living and group learning through which therapy principally occurs. The article closes with comments on the applicability of this model to residential child care practice generally.     

Organising Work and Home in Same‐Sex Parented Families: Findings From the Work Love Play Study

In this article we present findings from the Work, Love and Play (WLP) study: a survey completed by 445 same‐sex attracted parents across Australia and New Zealand. Comparisons of household division of labour are made between a sub‐sample of WLP participants, who were currently cohabiting with a same‐sex partner (n = 317), and 958 cohabiting opposite‐sex parents surveyed as part of a major Australian study, Negotiating the Life Course. This comparison showed that same‐sex couples divided household labour significantly more equally than heterosexual parents, and lesbian couples also shared parenting tasks more equally. Qualitative findings from the WLP study indicate that, for many same‐sex couples, major decisions around who gives up paid work and how many hours parents choose to work, as well as decisions around work/family balance, are negotiated on the basis of couple's preferences and circumstance rather than an assumption that one parent will be the primary child carer. It is speculated that this finding highlights an important point of difference between same‐sex couples and heterosexual couples where the division of household labour is often based on the assumption that the mother will almost always be the primary child carer and homemaker. The research is a collaborative partnership between La Trobe University, Deakin University, The University of Melbourne, and Relationships Australia Victoria.     

The impact of expert evidence on care proceedings

There has been an increased demand for expert child psychiatric opinion in child care cases where social services have instigated care proceedings under the Children Act 1989. However, there has been little evaluation of this work in terms of whether such a referral changes the care plan of the referring social work agency or the outcome for the child. This article examines the contribution to care proceedings of assessment reports completed by a child and adolescent forensic psychiatry team in respect of 37 consecutive child care cases. All of the assessments were presented to court and the information was collated once the proceedings were completed. Our findings indicated that the court followed the recommendations of the child psychiatric report entirely in 73% of cases. In addition, in 86% of cases the social service departments reported that they had gained confirmation of their professional opinion. In only 10% of cases did they change their care plan in response to the child psychiatric assessment. In conclusion, the results suggest that in most cases social service departments are using child psychiatry expert evidence merely to validate and/or lend support to their original care plans. Copyright © 1999 John Wiley & Sons, Ltd.     

Social networks, informal child care, and inadequate supervision by mothers

The purpose of this study is to determine whether less informal child care support from family and friends is related to supervisory neglect and, if there is a relationship, to test several explanations for why some mothers receive less child care. Thirty-two low-income mothers who did not adequately supervise their children were matched to 32 mothers who provided adequate supervision. The results showed the mothers who provided inadequate supervision received less child care support from their partners and relatives, but not their friends. These differences appear to be linked to several properties of the mothers' social networks. For example, the majority of the mothers who provided inadequate supervision either did not have a partner or knew them for less than one year. They had fewer family members living nearby and more negative relationships with them than the mothers who provided adequate supervision. To reduce chronic supervisory neglect, mothers may need assistance with both informal and formal child care support.     

Sexuality,child care and social work education

Whilst it is important to acknowledge the holistic nature of sexuality and its relevance in all areas of social welfare and service provision, this paper is specifically concerned with lesbian, gay and bisexuality and child care. The issues discussed will be common to all service user groups but the insidious nature of the 'contamination or corruption' theories of homosexuality are particularly inflammatory for those working in the child care field and the young people with whom they work. This paper argues that the needs of lesbians and gay men, particularly young people, will continue to go unmet unless lesbian and gay issues are addressed explicitly in social work education and in a way which does not oversimplify what is an extremely complex task. Anti-discriminatory and anti-oppressive practice are central features of the academic and practice curriculum; however, it is not simply a matter of adding lesbian and gay issues to the ever-increasing list of oppressions. The ideology of heterosexism and a legal framework which endorses the discrimination of lesbians and gay men create additional challenges to working with this group of people. As social work education becomes increasingly government and agency led, with a competency model of assessment ruling the day, the realities of what social workers can achieve need to be acknowledged if we are not to be accused of perpetuating meaningless rhetoric; playing into the hands of those who refer to political correctness.     

Grassroots Networks: A Model for Promoting the Influence of Service Users and Carers in Social Work Education

We examine a process for involving service users and carers in a social work programme in Scotland and include the perspective of a service user involved in the development. We note the extent of service user and carer involvement within Scottish social work education. The Dundee system involves a regulated process of academics liaising with service user and carer groups in the locality, so that the expertise of service users and carers informs and influences social work qualifying training. The model is built on current ideas surrounding communication networks that work in non‐hierarchical ways. The paper emphasises the importance of basing a system on shared values and overcoming tokenistic approaches to involvement.