Do we care? Adult mental health professionals' attitudes towards supporting service users' children

The impact of parental mental health is well known, but children's very existence may fail to be recognized by adult mental‐health services. This study aimed to explore attitudes of mental‐health professionals in one outer London borough regarding support needs of mental‐health service users' children to highlight potential barriers to identifying or meeting their support needs. All statutory mental‐health teams in the borough participated in a cross‐sectional survey. The response rate was 62.8% (n = 94) out of 150. The sample consisted of a diverse range of professionals from both inpatient and community settings. The main finding was that practitioners were overwhelmingly in favour of supporting children. However, attitudes and practices were significantly associated with profession, setting and whether the respondent was a care coordinator. Demographic characteristics or experience was not associated with attitudes. Perceived barriers to supporting children are highlighted. In particular, the mental‐health professionals in our sample considered supporting children important but did not necessarily consider it their role to do so. Training is required to raise awareness about this issue.     

Putting the child at the centre of inter‐professional cooperation in out‐of‐home care

A large part of most children's childhood is about taking part in educational and leisure‐time activities together with other children across various contexts. However, children in out‐of‐home care do not always have easy access to these possibilities for participation. In general, parents coordinate their children's everyday lives, but in the case of children in out‐of‐home care, the responsibility of care is distributed between several professionals and institutions. Research often recommends that inter‐professional cooperation should put the child at the centre and be more child focused. But what does that mean? The paper investigates theoretical understandings of ‘child centredness’ in inter‐professional cooperation. It also includes an empirical example taken from a research project that followed four children in their everyday lives in two residential homes in Denmark. The research explored how professionals work together across contexts in order to support children to take part in school and leisure‐time activities. The overall reasoning leads to the point that for children in out‐of‐home care, the possibility of exercising personal agency in their everyday life constitutes a difficult but vital issue. How children in out‐of‐home care learn how to conduct their everyday lives, is closely related to the ways professionals cooperate across contexts. It points to the need for close inter‐professional cooperation in order to encourage and support children's initiatives and engagements in activities in communities with other children.     

The proof of the pudding: What difference does multi‐agency working make to families with disabled children with complex health care needs?

More than 20 years of research with disabled children, young people and their families has highlighted the need for the different professionals and services that support them to work more closely together. The British policy and legal framework for ‘joined up working’ has never been stronger. However, there has been an assumption that multi‐ or inter‐agency working will inevitably be a ‘good thing’ for families. This paper discusses findings from a 3‐year research project which looked at both the process and impact of multi‐agency working on families with a disabled child with complex health care needs. Interviews with 25 parents and 18 children and young people who used six developed, multi‐agency services were carried out. Findings suggested that the services had made a big difference to the health care needs of disabled children but were less able to meet the wider needs of the child and the family – particularly in relation to social and emotional needs. Multi‐agency working appeared to make some positive, but not significant, differences to the lives of families.     

Barriers to collaboration on behalf of children with challenging behaviours: a large qualitative study of five constituent groups

Inter‐agency collaboration is seen as an effective way to support children and families with multiple and complex needs. Children in out‐of‐home care, especially those exhibiting challenging and disruptive behaviour, often require the services of multiple agencies. Ninety‐two South Australian stakeholders experienced in supporting children in out‐of‐home care were interviewed about their experience of collaborative practice, using the specific example of supporting children with extremely challenging behaviour. Participants were teachers, foster parents, child welfare workers, child mental health professionals and residential care workers. Thematic analysis revealed several tensions inherent in such collaboration. Results are discussed in terms of their unique implications for managing challenging behaviour, and suggestions are made for improving collaborative approaches to behaviour and multi‐agency practice.     

Measuring Children's Church‐Based Social Support: Development and Initial Validation of the Kids’ Church Survey

Given the importance of considering context in development, the goal of the present study was to develop and provide initial validity evidence for the Kids’ Church Survey (KCS), a new measure of children's church‐based social support. Data were collected from 1253 children ages 6–14 attending mainline Protestant, evangelical Protestant, and Catholic churches. Parallel and exploratory factor analyses supported a three‐factor solution: received (emotional) church support, perceived church support from peers, and perceived church support from adults. Confirmatory models conducted with independent samples provided an excellent fit for the data. All three scales evidenced acceptable internal (.78–.92) and test–retest (.88–.95) reliability. Measurement invariance was demonstrated across genders and age groups, with the exception of the perceived peer support scale, which was not invariant across ages. The KCS was sensitive to between‐church differences in children's programs and incrementally predicted self‐esteem, prosocial behavior, and spirituality. Applications for researchers, mental health practitioners, and clergy are discussed.     

Emotion in responses to the child with ‘additional needs’

The work that is done with children and young people by the practitioners of health, education or social care forms part of their experience of growing up, and can have a profound impact on their future outcomes. Children may find themselves ‘impotent at the hands of powerful others’, particularly where their behaviour causes concern. This paper reports on a key theme from the author's doctoral research, demonstrating the ways that the emotion‐laden interactions between practitioners in multi‐agency children's services, children and parents, affected the diagnosis, treatment, communication and outcomes for children's well‐being, as defined within Every Child Matters. Exploring the emotion within interactions permits a different perspective on ‘need’, and finally, the paper argues for a more careful and emotionally reflective practice from those who work with children.     

Partnerships with children in child welfare: The importance of trust and pedagogical support

Within the context of Norwegian Child Welfare Services, children's best interests are often promoted through inter‐professional collaboration. Although children have the right and desire to participate, research reveals that professionals do not listen to them. On the basis of qualitative interviews with 10 children about their experiences collaborating with professionals, we have identified ways in which professionals can facilitate children's participation. The findings show that trusting relationships, emotional support, and pedagogical approaches increase children's participation in their interactions with professionals. The results show the importance of including a relational understanding of participation as a theoretical concept in child welfare and an awareness that power and dominance are in play.     

From ‘Rights to Action’: practitioners' perceptions of the needs of children experiencing domestic violence

Not only has research over the past decade documented the emotional and behavioural consequences for children who witness domestic violence, but a number of studies have used children as participants thus, giving them an opportunity to describe their experiences in their own words. In policy terms, there has been a growing emphasis on children's rights and the importance and understanding of children's perspectives on their own lives. Consequently, children can no longer be perceived as forgotten victims where domestic violence is concerned. This paper explores practitioners' awareness of the needs of children and young people living with, and fleeing from, domestic violence. The research, conducted in a rural area in Wales, reveals that although the views of practitioners reflect the concerns reported by young people in other studies, there can be barriers to meeting these needs. While policy prescribes engaging with children, at the institutional level, operational priorities and increasing administrative demands can actually reduce opportunities for working directly with children. These demands may hamper the development of multi‐agency practice.     

Safeguarding children: challenges to the effective operation of core groups

Founded on an evaluative review of core group practice in a northern metropolitan borough of England, this paper highlights the tensions and difficulties that might inhibit the quality of post‐registration services to children and their families. Insights from the empirical data as well as theoretical literature have been explored in the light of current and developing policies. This exploration is focused on inter‐agency coordination; inter‐professional relationships; and partnership with parents and children. The recruitment and retention of social workers, the potential contribution of Children's Trusts, as well as unconscious processes relating to child abuse and child protection, are all given consideration.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

Self-perceived Social Acceptance and Peer Social Standing in Children with Aggressive–Disruptive Behaviors

Examining children's perceptions of their social acceptance in conjunction with others’ ratings of their peer social standing can enhance our understanding of the heterogeneity in children exhibiting disruptive behavior problems. Using a sample of 213 youth rated in the top 31 percent of their class on aggressive–disruptive behaviors, the current study examined the interaction between children's perceptions of their social acceptance and their peer‐rated social standing in predicting emotional and behavioral problems. Overall, lower peer‐rated social standing was associated with higher levels of antisocial behavior, academic problems, and hyperactivity/inattention. On the other hand, higher self‐perceived social acceptance was associated with increased levels of peer‐rated fighting at school. For children who were rated as having high social standing among their peers, poorer self‐perceived social acceptance was associated with increased oppositional behaviors and conduct problems at home. In addition, children who reported lower self‐perceived social acceptance exhibited increased levels of depressive symptoms, even when they were relatively well liked by their peers. The potential implications for working with subgroups of children with aggressive–disruptive behaviors are discussed.     

Variability in the Inter‐group Attitudes of White Children: What We Can Learn from Their Ethnic Identity Labels

The current study examined the ethnic identity of White (N = 120), Latino (N = 87), and African‐American (N = 65) children and early adolescents (aged = 9–14 years), with an emphasis on whether the specific ethnic label White children used to describe themselves might reflect differences in their inter‐group attitudes and whether those differences mirror group differences between White children and children in ethnic minority groups. Results indicated that White children who identified with a minority label (i.e., White biracial, hyphenated American, ethnic/cultural/religious label) had more positive ethnic identities, were more aware of discrimination, and were less likely to show biases in their perceived similarity to in‐group and out‐group peers than youth who identified as White or American. In many instances, White children who identified with a minority label did not differ from ethnic minority youth. In addition, although all participants were more positive about their ethnic in‐group than out‐groups, children who identified their ethnicity as American were less positive about out‐groups relative to other children. Taken together, the findings indicate that children's self‐chosen ethnic identity is as important as their ascribed ethnic or racial identity in predicting their inter‐group attitudes.     

Facts with feelings – social workers' experiences of sharing information across team and agency borders to safeguard children

This paper reports findings from a psychosocially informed case study of information sharing across team and agency borders, carried out in three children and family social work teams within one local authority. The study investigated practitioners' understanding and experiences of information sharing, the tasks, processes and technologies involved, as well as perceived barriers and facilitators. It also considered how the emotional and social dynamics of working contexts could impinge upon information work. Practitioners described information tasks relating to collecting, interpreting, communicating and recording information, guided by the demands of rigid organizational protocols. Performance of these tasks was, however, infused by the emotional complexities of child protection work, presenting a number of challenges for practitioners seeking robust and reliable information in the midst of ambiguity, complexity and heightened emotions. For practitioners across all teams, information work, and information itself, was both cognitive and affective and often at odds with linear processes for its exchange across team boundaries, designed to filter out all but hard evidence. Increased recognition of the dual nature (facts and feelings) of information and information work, throughout the safeguarding process, has potential to enhance the generation of shared understandings and collaborative practice across team and agency borders.     

Caregiver involvement in behavioural health services in the context of child welfare service referrals: a qualitative study

Human service agencies serve a growing number of adults with behavioural health needs. Despite these agencies' key role in identifying need and facilitating services, many individuals do not receive care or end services prematurely. Few studies have explored the experiences of families referred to behavioural health services by such agencies or the extent to which families' perceptions of service need align with those of treatment providers and frontline workers. This study presents findings from a qualitative study of caregivers involved with child welfare agencies who were referred to behavioural health services. Researchers reviewed agencies' case records and conducted in‐depth interviews with 16 caregivers, 9 child welfare caseworkers and 12 behavioural health treatment counsellors. Findings suggest that when deciding to engage in services, caregivers weigh not only their individual and family behavioural health needs but also potential agency intervention, including loss of child custody. Many professionals reported that involvement with a child welfare agency hindered the caregiver's disclosure of behavioural healthcare needs. Implications for managers and practitioners are discussed.     

Implementing Local Safeguarding Children Boards: managing complexity and ambiguity

Local Safeguarding Children Boards (LSCBs) were established under the Children Act 2004 and have responsibility for coordinating and ensuring the effectiveness of the work of partner bodies to safeguard and promote the welfare of children. Drawing on data from a Department for Children, Schools and Families and Department of Health‐funded evaluation, the paper examines the development of LSCBs and the challenges and issues that have been encountered by Boards in implementing new arrangements. In doing so, the paper contributes to current debates about some of the limitations of New Labour's safeguarding reforms as a vehicle for improving outcomes for children and families.     

Mother–Child Reminiscing About Peer Experiences and Children's Peer‐related Self‐views and Social Competence

This study examined mother–child reminiscing about children's experiences with peers and its relation to children's peer‐related self‐views and social competence. Sixty‐three mothers and their preschool‐aged children discussed at home two specific past events involving the child and his or her peers, one event being positive and one negative. The children's self‐views in peer relationships were assessed at school during individual interviews, and their social competence was rated by mothers. Both maternal and child participation in the reminiscing, in terms of reminiscing style and content, were uniquely associated with children's peer‐related self‐views and social competence. The results suggest the important role of family narrative practices in children's social development.     

Agreement and discrepancy between children,parents, and social workers on school‐based effort avoidance in child welfare services

A multiperspective approach is beneficial for obtaining reliable and multifaceted pictures of child behaviour problems. The goal of the present study is to examine interrater agreement on school‐based effort avoidance between children receiving child welfare services, parents, and social workers. Given previous findings, interrater agreement is expected to be low. Self‐reported data on school‐based effort avoidance were gathered for children and adolescents in child welfare services. Additionally, social workers (using the Teacher‐Report Checklist for social and learning behaviour) and parents (using the parallel version of the self‐rating questionnaire on school‐based effort avoidance) were asked to complete an external assessment tool to compare children's perspectives with the ratings of significant adults. The results confirmed significant discrepancies between parents' and children's ratings on effort avoidance tendencies. Furthermore, there were only small to moderate correlations between children's self‐ratings and the adults' assessments; however, the consensus between adults was higher than the interrater agreement between children and social workers. Discrepancies in ratings from multiple informants underline the importance of integrating multiple perspectives, especially children's perspectives, in the diagnostic process in order to plan and adapt appropriate care and treatment.     

Children's agency in interprofessional collaborative meetings in child welfare work

The concept of children's agency can be used to understand how children actively shape their lives. While in social work there is a growing body of research on how children experience meetings that involve collaborating professionals, little is known about the ways in which they exert an influence. The purpose of the study is, in a Swedish context, to investigate children's perceptions of their agentic capacity in regulating participation and exerting an influence on outcomes in interprofessional collaborative meetings. Interviews were carried out with 28 children in receipt of social services support. Findings revealed that children perceive professionals' talk as restricting opportunities for input. They also perceive that they have the capacity to exercise agency by (i) conforming to expectations by feigning boredom and seeming disengaged, but at the same time paying close attention; (ii) by using exit strategies; and (iii) by developing ‘in‐situ’ strategies to end meetings. Rather than, as previously suggested, being powerless in such circumstances, the children tell how they carefully assess situations, and, from a position of apparent subordination, talk of ways of acting that reveal their agentic capacity. These insights are of importance for practitioners who are encouraged to look beyond behaviours that first meet the eye.     

‘Creating NHS Local’: The Relationship between English Local Government and the National Health Service

Following recent reforms of both local government and the National Health Service, there is significant emphasis in both services on improving inter‐agency collaboration, user involvement and strategic commissioning. In response, this article reviews historical debates about the relationship between local government and health care, before arguing that these two ‘partners’ need each other now more than ever. If local government is to be a ‘place‐shaper’, then it needs significant influence over local health services, while the NHS needs to learn from the best of local government if it is to gain sufficient local legitimacy to take the difficult decisions it needs to take. Against this background, the article reviews different options for future joint working, exploring various options for enacting a new relationship between local government and the NHS.