Supporting families: Outcomes of placement in voluntary out-of-home care for children and young people with disabilities and their families

Parents caring for children and young people with disabilities typically have extensive additional demands on their time and resources. This added pressure can significantly impact well-being and mental health. In extreme circumstances, parents may seek an out-of-home placement for their child. Previous research has looked into factors that influence decisions for families to place their child into out-of-home care but little is known about outcomes for these young people and their families. The Supporting Families study aimed to explore the impact of a voluntary out-of-home placement on young people with disabilities, and consequences for their families. Fourteen parents/carers, twenty six case managers, six accommodation services' managers, and four young people with disabilities participated in face-to-face and telephone interviews and focus groups. Participants reported a range of outcomes for young people in care. Positive outcomes included increased levels of respect for themselves and others, an improvement in independent living skills, and reductions in challenging behaviours. Negative outcomes centred on their experiences of grief, loss and rejection, as well as behavioural problems. Positive and negative outcomes were also found for families. For many parents/carers there was a reduction in perceived stress and caring load, as well as improved mental health and wellbeing for them and the child's siblings. However, parents/carers often experienced ongoing feelings of guilt, grief and loss. The study adds to knowledge about outcomes of being in voluntary out-of-home care for this small but vulnerable group of young people in care and their families.     

Financial assistance for families with severely disabled children and transport costs

Families with severely disabled children encounter many difficulties in getting out and about. The inadequacy of statutory financial assistance for transport related costs is confirmed by an analysis of families receiving grants from the Family Fund Trust. A third of the sample of 37 000 families with a severely disabled child, received grants for transport related costs. Such grants were more common for families with very young disabled children, children with particular diagnoses, or severely impaired motor function, sight and speech, and families whose children were dependent on technology, or who subsequently died. Recommendations for improving current statutory support are made. Copyright © 1999 John Wiley & Sons, Ltd.     

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.     

Kidney-transplanted children and their families: A social worker's experience

Abstract

This paper describes approaches to the problems of families with children who undergo kidney transplanation and the emotional stess experienced at different phases of assessment and treatment.

Thirty-seven families were studied. The author describes family-oriented interviews in preparation for transplantation, supportive conferences, counselling and other forms of socioeconomic support.

Previous literature shows that where the family has been given sufficient time for emotional preparation and adaptation mere are fewer problems. I have compiled information given by the patients after transplantation concerning social contact, isolation, school problems, dependency, emancipation, growth inhibition, and discrepancy between physical and psychological development. These problems seem to be most pronounced around secondary school-age/puberty.     

‘Access and achievement or social exclusion?’ are the government's policies working for disabled children and their families?

The past decade has seen significant developments in policy and practice for disabled children and their families. In particular there is a new focus upon access and inclusion, with increasing awareness of the need to see disabled children and families as active partners within policy development and implementation. There is growing awareness of the implications of disability discrimination legislation across children's services and of the importance of improving arrangements for early identification and intervention to maximise disabled children's participation within mainstream services. The National Service Framework, the advent of Children's Trusts and a new Special Education Needs (SEN) Action Programme, together with the introduction of direct payments, give encouraging messages about multi‐agency working and a strategic and ‘joined up’ approach to childhood disability. However, many disabled children and their families continue to experience discrimination, poverty and social exclusion. The challenge for the Government is to ensure that disabled children are ‘mainstreamed’ across all policy initiatives and to recognise the talents and ambitions of disabled children and their families in service design and implementation. Copyright © 2003 John Wiley & Sons, Ltd.     

Managing turning points and transitions in childhood and parenthood – insights from families with disabled children in Norway

This article explores turning points and transitions emerging in the life course of children with disabilities and their parents. Through in‐depth interviews with parents we found that a change appears in disabled children’s social participation and belonging, at approximately eight years of age for children with learning difficulties and at approximately ten years of age for children with mobility difficulties. Most of the parents experienced a ‘turning point’ that directed them into either marginal or inclusive positions in adulthood. The ‘transition’ emerges at a time described as a stable period of life for families in general and illustrates parents’ experiences of the importance of both ‘doing’ and ‘being’ in parenthood and childhood. Parents’ experiences are strongly interwoven with the child’s life and access or lack of access to services and relational responses.     

Effective child welfare practice with immigrant and refugee children and their families

This article presents a multistage migration framework to broaden the lens through which child welfare personnel can view immigrant and refugee families and their children. By better understanding the family's experiences in both emigration and immigration, including reasons for leaving their home country, experiences in transit, and reception and resettlement experiences in the United States, child welfare personnel are better equipped to assess their needs and provide effective prevention, protection, permanency, and family preservation services. Case examples illustrating the application of the framework and guidelines for program and practice are included.     

Counseling severely dysfunctional families of mentally and physically disabled persons

Some families of mentally and physically disabled persons behave in an extremely self-destructive or resistant manner. These severely dysfunctional families pose a formidable obstacle to their disabled relatives' habilitation. Because such families are particularly frustrating to work with, little professional assistance has been provided to them. This article examines probable causes of severely dysfunctional family behavior, details several maladaptive family patterns and suggests practical treatment strategies for helping these families.     

Gone Missing? Disabled children living away from their families

Many disabled children spend most of their childhood in 'care', but not formally 'in care'. Research concerning disabled children has been dominated by a medical model of disability and by a failure to include the subjective reality of children themselves. There is also inadequate statistical information available concerning children who spend most of their time away from a family setting. The article looks at what we do know about such experiences, identifying some issues for future research.     

The effects of adapting their home on the meaning of home for families with a disabled child

This article describes part of a mixed-method study investigating family and professional perspectives on home adaptations for disabled children. The methods were an online survey of staff involved in adaptations processes (n =39), semi-structured interviews with families with disabled children (n = 48) and an online survey for families (n = 16). One of the wider study’s recommendations was that families need to be enabled to engage with processes proactively. This article focuses on families’ experiences of the meaning attributed to adapting the home and highlights that, although satisfied with the completed adaptation, families were dissatisfied with the process they had been through. Thus, despite the need for the meaning of home being central to the adaptation process, families felt excluded from the process as it progressed. This had a negative impact on the continuing use of the adaptation and affected the meaning of home for families with a disabled child.     

Addressing the impact of foster care on biological children and their families

This study explores from a dual perspective the impact of the fostering process on biological children in the home. Ten foster parents and their biological children were interviewed separately. The impact of foster care on the psychological, educational, and social well-being of biological children and their relationship with parents and siblings were examined. The exploration reveals a paradoxical and life-changing process as seen through the eyes of biological children and their parents.     

Services for emotionally disturbed children and their families: a personal view

SUMMARY. The invitation to contribute to Children & Society coincided with the writer's official retirement from child psychiatric practice. The development of services, clinical, training, teaching, and research has been an ever present challenge throughout. With just enough sense of ‘distance’ to aspire to a feeling of perspective, but not jet too remote from the scene, the author sets out a personal view of the services for emotionally disturbed children and their families. While progress is painfully slow he concludes that there is sufficient goodwill to achieve some real improvements.     

Swedish welfare responses to ethnicity: the case of children and their families

This article focuses on issues of racism and ethnic discrimination in the operation of the Swedish child welfare system and the broader societal context. It draws primarily upon a qualitative study which explored discourses about ethnicity, gender and age within the Swedish child welfare system but also uses some data from several recent transnational European studies. It suggests that the Swedish welfare system may be far less benign in challenging racism and ethnic discrimination than it is when assessed along more ‘mainstream’ comparative measures associated with poverty alleviation or issues of work in the labour market and home. The article notes that very similar findings occur when gendered violence to women and children is placed in focus rather than ethnicity. Finally some tentative possible explanations for these welfare patterns are suggested as the basis for future research and elaboration.