Research Review: Risk and protection in the context of services for children in need

The paper summarizes the evidence and provides definitions of risk, protective factors, resilience, coping strategies and need in the context of children in need. Definitions are offered for children in need and children's services. The way in which individual interpretation can alter objective assessment of risk is explored. A method for recording evidence relevant to clinical practice on behalf of children in need is offered. Implications for policy and practice are discussed.     

Risk and resilience factors for substance use among street adolescents: Assessment and development of an integrative model

In this study, risk and protective factors for substance use were explored to develop an intervention program and test its efficacy among male street‐based adolescents. Twenty expert interviews and key informant interviews were conducted. In addition, 30 street adolescents (15 substance‐users and 15 non‐users) participated in four focus group discussions for needs assessment, wherein risk and protective factors were discussed. Based on the identified needs, an intervention package was developed and validated by experts. The package was implemented in a natural environment of 50 street adolescents. After the intervention, about 60% of the respondents quit or cut down on their substance use substantially, and approximately 40% of the respondents agreed to reunite with their respective families, while 20% did not change their substance use habits. The results showed that if several protective factors were present, there was a lower risk of substance use. Many factors contribute to substance use and protective factors need to be strengthened in order to make interventions effective.     

Assessment of the developmental needs of children in need: Estonian child protective workers' case reflections

Child protective workers must be able to evaluate children's developmental needs in order to assess problems and delays. Skilful and comprehensive assessment leads to outcomes for children that promote their well‐being and development. This paper presents the findings of a qualitative study on a sample of Estonian child protective workers that investigated their assessments of the developmental needs of children in cases with child protection concerns. Only half of the child protective workers considered some dimension of the child's developmental needs in their assessment, suggesting a profound need to incorporate a developmental assessment framework and implement training of such in Estonia to increase child protective workers' competencies to conduct consistently comprehensive assessments.     

Predicting chronic neglect: Understanding risk and protective factors for CPS‐involved families

Child neglect continues to receive less attention in research literature compared to other forms of maltreatment, despite accumulating evidence of serious negative impacts on child well‐being. Chronic neglect is also poorly understood. Although such cases comprise a relatively small percentage of workers' caseloads, they represent accumulation of harm that impacts the cognitive and social development of children. These cases can also disproportionately utilize protective service resources. This study contributes to the literature by examining risk and protective factors of chronic neglect. We utilized administrative data (N = 2,074) from a midsize city in the Northeast to examine the use of existing risk assessment tools to distinguish families with and without chronic neglect, including an analysis of the predictive capacity of risk and protective factors. We found that families with chronic neglect were younger, had more children, were more likely to have children under age one, and had higher rates of domestic violence, mental health problems, and cognitive impairment. None of the assessed protective factors differed significantly. The overall predictive value of the assessment was low. Implications include the need to expand risk assessment tools to incorporate patterns over time and identify early indicators specific to chronic neglect.     

Children's understanding of mental ill health: implications for risk and resilience in relationships

Research shows that having a parent with a mental health problem has associated risks for children, but some families seem very resilient and do not always suffer these difficulties. In order for social workers to be able to support the development of resilience in families who appear to be at risk, we need to understand what factors may ameliorate some of these risks. Research seems to suggest that children who can conceptualize their parent's mental health problem as something 'outside' their representation of that parent as an attachment figure are likely to have better outcomes than children who see the mental-health problem as part of, and embedded within, their representation of that parent. However, in order to develop an understanding of how this conceptualization affects attachment relationships and outcomes, we need to know what children understand by mental ill health. We also need to consider how this conceptualization might be changed, and it appears that parents, other attachment figures and other support figures may play a key role here. This paper provides a selective review of the research area and discusses the mechanisms which may govern this complex process. The review concludes with recommendations for future research and practice.     

Children and Violence: Nurturing Social-Emotional Development to Promote Mental Health

The absence of violence against children is a fundamental children's right and a major milestone of civilized society. Similarly, reports on incidences of violence by children and youth, including severe cases with devastating consequences, speak to the need that the trauma of exposure to violence in childhood needs to be addressed. While violence and its risk factors are generally understood, what is less clear are the essential protective factors, how we can identify those as early as possible, and how we can use them to prevent and address the trauma of violence exposure in children and youth. In this report, I review pathways of child and youth violence through the lens of social-emotional development as a central protective factor. Negative emotions of frustration and anger can underlie violence and aggression. Kind emotions, such as caring and our ability to connect with others emotionally, can serve as social-emotional protective factors. A brief review of the central social-emotional processes and their development is provided, including the human capacity to feel with others and express empathy, be emotionally aware and care about the effects of one's own actions on others, and be able to regulate the self and their emotions. Given the negative widespread and long-term impact of exposure to violence, I describe research-informed attempts to prevent violence exposure across development. Taking a humanistic, strength-based perspective, the focus is on social-emotional protective factors to address violence and nurture mental health in every child. I conclude with recommendations for practice and policy.     

Unmet Needs and Depressive Symptoms Among Low-Income Older Adults

Previous studies have found that declining health, decreased social interaction, and inadequate financial resources were significant risk factors for late-life depression, and social support from families and friends and religiosity were significant protective factors. In this study, we examined if low-income older adults' perceived unmet need for home- and community-based services for many aging-associated problems would be independently associated with their depressive symptoms, controlling for these known risk and protective factors. We interviewed a total of 213 community-residing older adults to assess their depressive symptoms, using the Geriatric Depression Scale (GDS), and unmet needs in the areas of personal assistance, instrumental and environmental support, emotional support, and other facilitative/enabling services. We found that the number of unmet needs was significantly positively associated with these older adults' depressive symptoms, although it explained only a small proportion of the variance of the GDS scores. Future research and practice implications are discussed.     

Postpartum depression and its correlates in middle‐class women in Hunan,China

Postpartum depression (PPD) has a negative impact on both infants and women. The middle‐class group is rapidly expanding with increased but unmet psychological needs. To determine the risk and its correlates of PPD in middle‐class women in Hunan, China. A sample of 306 middle‐class puerperae from obstetric wards of a large general hospital was enrolled in the study. Our results showed 55.6% middle‐class women were suspected PPD. Related risk factors included a history of complications, pregnancy stress, subjective support, and interaction effect between objective support and negative coping. The protective factors included objective support and an interaction effect between subjective support and negative coping. Early assessment and individualized guidance in terms of social support and coping to identify and prevent PPD in this population are required.     

Ontario child protection workers' views on assessing risk and planning for safety in exposure to domestic violence cases

The use of standardized tools to assess risk for children is mandatory in the child protection sector in Ontario. Factors that can be used specifically to assess the risk of lethality in exposure to domestic violence (DV) cases, however, are largely missing from these tools. Using data from an online survey of 138 child protection workers in Ontario, the current study examines practitioners' risk assessment and safety planning practices with DV cases. Findings provide an overview of the frequency of risk assessment and management strategies within various environmental contexts (e.g., urban and rural) and populations (e.g., indigenous and immigrants/refugees). According to the practitioners sampled, assessing and managing risk are frequently and consistently completed across the province, although specific strategies and challenges vary. Although mandatory provincial child protection tools are commonly used, some workers report using other specific DV risk assessment tools to complement their own measurement of risk and planning for safety. Respondents emphasized the importance of working collaboratively with families and professionals in other sectors to address risk. Implications for future research include exploring the barriers and challenges of using DV‐specific risk assessments in child protection and factors contributing to these challenges as identified by practising child protection workers.     

Mothering and child protection practice: rethinking risk assessment

In recent years, across North America and the UK, child protective service agencies have increasingly begun to rely on bureaucratic, technocratic, and regulatory mechanisms for detecting and managing abuse and neglect. Coupled with a shift from concern for the general social welfare of children to a heightened preoccupation with risk or dangerousness to children, risk assessment systems are becoming integral to child protection practice.
Though risk assessment systems aim to enhance the effectiveness of child protection investigations and service provision, as well as filter out high risk cases from the rest, such systems may foster and reproduce often concealed relations of gender, race, and class. This paper presents a review of the risk assessment trend in child welfare, its general objectives, and some criticisms raised to date. Through a feminist analysis of the social construction of mothering, we re-examine risk assessment. We argue that the risk assessment trend has the potential to entrench oppressive relations of gender, race, and class in child welfare practice with mothers. We suggest that an approach to risk assessment which incorporates a 'mothering narrative' might offer a more thorough evaluation of the conditions that shape the context within which risk to children emerges.     

Towards best practice: combining evidence‐based research,structured assessment and professional judgement

Limitations of instruments adopting consensus and actuarial approaches are well documented when assessing risk of abusive behaviour. Whilst the consensus approach is flexible and useful for structuring information, it relies upon the practitioner's ability to combine information and apply knowledge of empirical research. The actuarial approach involves a graduated probability measure in the form of a score that determines the likelihood of a particular event occurring; however, this approach focuses upon static risk factors and tends to be inflexible given its necessary reliance on nomothetic factors. A third approach, structured professional judgement comprises evidence‐based risk factors and decision‐making guidelines to inform professional judgement and standardize assessments. Instruments focus upon dynamic risk factors that assist practitioners monitor risk levels and manage risk. This approach is useful for social work practice that commonly requires ongoing risk assessments and risk management. Structured professional judgement has not been meaningfully explored in Australian child protection practice despite it being used successfully for approximately two decades for assessing a range of offending and violent behaviour. Given the complexity of child protection cases, further research on approaches to risk assessment that combine evidence‐based research, structured assessment and clinical judgement, is warranted.     

需求与回应:一项关于流动儿童适应的再研究

人类有潜能帮助其自动地调适以寻求与环境的平衡,但人类的天赋与环境资源供给的相互作用才是增进人类适应的最终因素。流动儿童在与环境的互动中,资源供给欠缺,影响其适应。为了回应流动儿童的需求,需要从环境层面输入资源,培养其积极的自我认知与情绪体验,帮助其适应以寻求与环境的平衡。由于城乡间的差异给流动儿童带来的不适应、断裂及社会排斥,持续性的多系统整合介入是帮助流动儿童适应的重要因素。     

Research Review: Risk and resilience in cases of emotional abuse

This paper examines risk and resilience in relation to emotional abuse. Research has identified numerous child and family factors that may increase the risk of emotional abuse occurring and has also identified numerous ways in which an experience of emotional abuse can enhance vulnerability to negative outcomes. However, relatively little is known about the factors that determine the extent to which an experience of emotional abuse predicts later psychosocial functioning. Factors that may determine risk and resilience in children who experience emotional abuse are discussed. These include predisposing factors such as early caregiving experiences; precipitating factors such as the frequency, intensity and duration of the abuse; factors intrinsic to the child such as working models of the self and others, internal or external attributions, behavioural and coping strategies, self‐esteem, and disposition; and external factors such as school and availability of supportive relationships. The need to pay attention to the particular vulnerabilities and protective factors pertaining to each emotionally abused child in order to most effectively enhance resilience is highlighted.     

Chronic child abuse and domestic violence: children and families with long‐term and complex needs

It is estimated that up to one million children may have been exposed to domestic violence in the UK, with significant consequences for their social and emotional development in childhood and later life. At a time when the central and devolved administrations in the UK have developed strategies to tackle domestic violence, this paper reports the findings from a study conducted on children in the child protection system with long‐term and complex needs as a result of experiencing domestic violence. The research identifies the characteristics of the children and their families and tracks their careers through the child protection system. The findings indicate that professionals have an awareness of domestic violence, and that younger children with younger parents are most likely to experience prolonged periods in the child protection system. Domestic violence in this context typically co‐exists in families experiencing other difficulties such as substance misuse and socio‐economic deprivation. In conclusion, the paper argues that Government policy and professional practice should primarily be concerned with assessing the risk that men present, rather than the risk that children are at. By reframing professional interventions, men are more likely to be challenged to accept responsibility for their behaviour and the consequences for their families.     

Welfare through Work: An Audit of Occupational Social Provision at the Turn of the New Century

Occupational welfare has been a relatively neglected area in both theoretical and empirical studies of the welfare state despite its importance to overall levels of social provision. Surprisingly, there has not yet been a comprehensive examination of British occupational social provision, as opposed to non‐wage benefits more generally or specific provision such as pensions, housing or childcare. This neglect can be explained both by the perception that occupational welfare plays a relatively insignificant role in contemporary welfare states and by a general lack of clarity regarding its definition and scope, factors which have added to the difficulties surrounding its conceptualization and measurement. Despite the lack of attention it has received, however, recent pressures have propelled the issue higher up the social policy agenda, increasing the need for a clearer conception of what constitutes occupational social provision and a more comprehensive assessment of its contemporary significance. This paper seeks to shed some light on to these areas by drawing on comparative and UK data in order to carry out an audit of occupational social provision.     

Key decisions in child protection services in cases of domestic violence: maintaining services and out‐of‐home placement

This paper looks at the response of the child protection services (CPS) system in cases where exposure to domestic violence occurs alone or together with abuse or neglect, focusing on the factors involved in decisions to maintain the case open for ongoing services or remove children from the home. The study is based on an analysis of clinical and administrative data from the files on children reported to a CPS agency in Montreal, Canada. A total of 1 071 substantiated reports were documented, including 337 cases of co‐occurrence (32%). Analysis of the data shows that domestic violence does not by itself constitute a factor liable to lead to more intrusive intervention. The CPS response appears to be influenced more by the existence of other forms of maltreatment and risk factors. Additionally, while domestic violence may be associated with more severe individual and family problems, it does not influence the decision to keep the case open because the child still need services. The lack of any connection between domestic violence and this decision is a cause for concern, as results indicate that such families need help. Knowing how to respond to their needs therefore remains a major challenge.     

Children living with parental substance misuse: A cross‐sectional profile of children and families referred to children's social care

Parental substance misuse is a significant public health and children's rights issue. In the United Kingdom, social workers frequently work with children and families affected by substance misuse. However, relatively little is known about this population, particularly at point of referral to children's social care. This paper reports on the largest known study of parental substance misuse as a feature of children's social care work in England. The paper provides a cross‐sectional profile of 299 children living with parental substance misuse and referred to children's social care in one local authority in England. Data were collected from social work case files at the point of referral to social care about the child, family, the wider environment, and parental substance misuse. The findings show that children affected by parental substance misuse frequently had other support needs relating to their well‐being and mental health. Children were also likely to be experiencing other parental and environmental risk factors. The significant historical—and in some cases intergenerational—social care involvement for some families indicates potential issues with the capacity of services to meet needs. Recommendations for practice are discussed with a particular focus on the need for early, comprehensive support for children and families.     

On the margins of the child protection system: creating space for relational social work practice

In the UK, a threshold divides between two categories of children, child protection (CP) and child in need. Each category tends to be treated as a homogeneous entity, despite containing heterogeneous levels and forms of risk and need. CP practice, accompanied by regulation, protocols and procedures, aspires to achieve a coordinated multi‐agency response to identified concerns with available resources targeted towards this category. However, it is well known that those children assessed as falling just below the CP threshold can still have high levels of need and risk, requiring a level of social work involvement beyond the low‐resource and low‐oversight model that generally accompanies a child in need categorisation. This paper probes an approach to practice, which divides levels of risk within the child in need category enabling adequate, coordinated support and oversight to be provided for children and families with complex needs. Evidence from our study evaluating this approach suggests that a simple protocol provided a clear process within, which social workers and agency partners felt confident and safe to practice outside of the formal CP framework. The protocol prevented drift and helped to create a space within, which relational social work practice flourished.     

“We felt completely left to ourselves.” Foster parents' views on placement disruption

The purpose of this paper is to explore the reasons for unintended placement disruptions in foster care. Based on a semistructured survey, the paper presents the views of 132 Norwegian foster parents who have experienced placement disruption between 2013 and 2015. Foster parents rated several relevant causes of placement disruption: the child's behaviour, the need for care, concern for the well‐being of their biological children, and lack of support from the Child Welfare Service (CWS). Although the child's behaviour was the cause most frequently reported in the quantitative data, CWS‐related factors such as poor collaboration, not being valued and listened to, insufficient support and follow‐up, and a mismatch between the child's needs and the foster carers' capacity were reported most frequently in the qualitative data. Placement disruption appears to be caused by the sum and interaction of several coexisting causes. It may not be the child's behaviour per se but rather the combination of challenging behaviour, concern for one's biological children, and insufficient support from CWS that lead to disruption. Good collaboration with the CWS in the form of respect, recognition, support, and follow‐up appears to be of the utmost importance in reducing the risk of placement disruption.     

Child effects in socialization research: Some conceptual and data analysis issues

This paper examines issues associated with the conceptualization of child effects in socialization research and outlines possible data analysis strategies that may be used with contemporaneous correlational data from parents and children. The paper begins with an outline of some recognized prohlems in the studv of child effects. The role of cognitive factors, which complicate efforts to disentangle child effects, is emphasized, in an attempt to clarify further the meaning of child effect, three different types of effect are outlined and then a distinction is made between moderator and mediator variables. In general, a moderator variable specifies when certain outcomes will hold (e.g. for one type of child but not another), whereas a mediator variable indicates how or why the outcome occurs. The distinction between moderator-mediator variables provides the main focus of the paper. It assists in the conceptualization of child effects, as well as having direct implications for data analysis strategies. The relevance of the distinction is illustrated via data from a study of family relationships. The use of correlations, multiple regressions with interaction terms, and latent variable path analysis are examined as ways of investigating moderator and then mediator variables. Conclusions are reached about conceptual and data analysis difficulties associated with attempts to determine child effects.