Beyond attachment theory and therapy: Towards sensitive and evidence-based interventions with foster and adoptive families in distress

Elements of attachment theory have been embraced by practitioners endeavouring to assist foster and adopted children and their parents. Attachment theory articulates the potential risks of experiencing multiple caregivers; emphasizes the importance of close social relationships to development; and recognizes that substitute parents may not always have close relationships with children who have experienced adversities before joining them. Attachment theory offers concerned parents what they believe to be a scientific explanation about their lack of the close, satisfying parent–child relationship they desire. Yet the scientific base of attachment theory is limited both in terms of its ability to predict future behaviours, and especially with regard to its use as the underpinning theory for therapeutic intervention with children experiencing conduct problems. There is a critical need to review the role of attachment theory in child and family services and to consider its place among other explanations for children's disturbing behaviour. An important step towards pursuing alternative approaches is for researchers and practitioners to understand the reasons the attachment paradigm appeals to so many adoptive and foster parents, given the apparent widespread prevalence of attachment‐based interventions. Such understanding might assist in the development of adoption‐sensitive uses of appropriate evidence‐based treatment approaches.     

Family relations, adjustment and well-being in a longitudinal study of children in care

The article reports on a longitudinal study of children placed in a children's home during the first two years of the 1980s. The 26 children placed when younger than 4 years of age and staying more than 4 weeks were followed up 3 and 9 months after leaving the children's home and 5, 10, 15 and 20 years later. The children's family relations, including early attachments and later parental relationships and the perception of who is their family, have been one of the predominant themes in the recurrent studies. None of them had lived with both parents after leaving the children's home and 20 of them had been in foster care for periods or permanently. At the time of the last study the children were young adults, aged 20–25. They are categorized in three rather distinct categories, one for those with a ‘good’ and one for those with a ‘moderate’ social adjustment and well‐being and one for those with a ‘bad’ social adjustment and well‐being insofar as involvement with drugs, criminal behaviour and legal sanctions are concerned. Their contacts and relationships with birth parents and foster parents and the perception of who is their family are analysed by use of attachment theory and developmental psychopathology.     

Enablers of help‐seeking for deaf and disabled children following abuse and barriers to protection: a qualitative study

Research internationally has highlighted the increased vulnerability of deaf or disabled children to abuse and the frequently inadequate response of services. However, first‐hand accounts of deaf or disabled children have rarely been sought. This paper reports selected findings from one of the first studies exploring experiences of deaf and disabled children regarding help‐seeking following maltreatment. Innovative and sensitive research methods were employed to support 10 deaf or disabled people (children and adults) to take part in guided conversations. The study identifies three enablers of help‐seeking of deaf or disabled children: the capacity of adults to detect abuse and respond to disclosures, supportive relationships or circumstances which facilitate disclosure and for Deaf children, access to registered interpreters. Barriers to protection related to these are also discussed. Recommendations directed at policy makers, practitioners and families include education and awareness raising amongst practitioners, children, parents and carers; addressing isolation of deaf and disabled children; providing comprehensive support services that address the needs of the child holistically; ensuring that the voice of the child is heard; routine access to registered interpreters for Deaf children within mainstream and specialist services and measures to address disablism at local and institutional levels.     

Returning children home from care: What can be learned from local authority data?

International Human Rights and child rights conventions as well as U.K. wide legislation and guidance require that children in care should be returned home to one or both parents wherever possible. Reunification with parents is the most common route out of care, but rates of re‐entry are often higher than for other exit routes. This study used 8 years of administrative data (on 2,208 care entrants), collected by one large English local authority, to examine how many children were returned home and to explore factors associated with stable reunification (not re‐entering care for at least 2 years). One‐third of children (36%) had been reunified, with adolescent entrants being the most likely age group to return home. Three quarters (75%) of reunified children had a stable reunification. In a fully adjusted regression model, age at entry, being on a care order prior to return home, staying longer in care, being of minority ethnicity, and having fewer placements in care were all significant in predicting chances of stable reunification. The results underline the importance of properly resourcing reunification services. The methods demonstrate the value to local authorities of analysing their own data longitudinally to understand the care pathways for children they look after.     

A tangled web: parental contact with children in kinship care

Contact between parents and children in care is a contested area. Parental contact is recognized to be important, yet may present protective issues; in the kinship care environment, it brings the particular challenges of complex family relationships. Seeking the parents' perspective in a child protection context is difficult and therefore under‐researched. This paper describes a nested study within an Australian research project on family contact in kinship care in which the perspectives of 18 mothers and 2 fathers were sought via in‐depth interviews. Mothers and fathers described strong feelings of disempowerment in the context both of their family and the child protection system. The relationship between parent and caregiver emerged as a significant issue. All of the parents wished to remain in contact with their children in a meaningful way, whether or not they were likely to resume their children's care; however, contact arrangements presented many difficulties for them. Mothers articulated the need for services that are more empowering and respectful, rather than oriented towards them as failed parents. In order to build appropriate models of support and intervention, we argue for a more inclusive conceptual frame for family life that gives greater recognition to the role of non‐custodial parents in the lives of their children.     

Evaluating a Case of Parent Separation in Social Services Through a Text Analysis: Clinical and Health Implications

Abstract

The assessment of the family system is very complex, as several factors have to be taken into account: The number of people involved (one or more children), the involvement of other partners, and the presence of legal disputes. Although evaluation practices have increased considerably, it remains difficult for services to prove their effectiveness. The questions that have guided this work have concerned how much and how do the discourses (discursive repertoires) produced by the conflicting parents change as a result of an intervention by the Service? And how much is it possible to evaluate the change in short texts? We used the Methodology for the Analysis of Computerised Text Data (MADIT) methodology that makes it possible to analyze the texts produced by the parents after the Service consultancy. The text is acquired through 14 emails sent by each parent to the other. The results showed that it was possible to detect a change in the repertoires used by the two parents to make decisions regarding their child. This data could increase the use of evaluation in the Services, reducing costs and evaluating change also by email. Future research could apply this methodology in situations where the conflict has not yet exploded and has not had an impact on children.     

Someone to check in on me: social capital,social support and vulnerable parents with very young children in the Australian Capital Territory

Although knowledge of how social support can mediate stress is now well known, finding ways to enable isolated parents to access social resources that could make a positive difference for children during their critical early years remains difficult. This paper reported on the findings of a telephone survey aimed at understanding levels of social capital and social support experienced by isolated parents raising young children on their own in Canberra, Australia. Specifically, it discussed a successful methodology for reaching isolated parents, those whom services find hard to reach. The survey found that despite the relative affluence of Canberra's population, there is a significant group of parents who are isolated from both formal and informal support and the social capital that can help them cope with the stresses and demands of raising young children. These parents were unsure where to get parenting information and had a strong sense that they were judged by their local communities and services. We identified lost opportunities by general practitioners and other widely used systems such as public housing and security to take more proactive roles and connect parents to formal service support systems. Flexible, affordable child care was identified as an unmet need for these parents, not only as a source of relief from extreme isolation but also to enable them to work or prepare for work through study.     

Positive Connections: a programme for children who have a parent with a mental illness

Mental health professionals working with parents who suffer from a mental illness often overlook the children within the family. Children whose parents are mentally ill face numerous obstacles to their own emotional development and these children are at higher risk for developing mental illnesses than other children. These risks can be decreased if protective or positive interventions are available for the children. This article will describe the development and implementation of Positive Connections, an effective intervention programme specifically designed for children whose parents have been diagnosed with a mental disorder. The effectiveness of this programme has been evaluated using both qualitative and quantitative research strategies, and the results are presented.     

Early outcomes for young adults transitioning from out-of-home care in the USA

This paper describes the well‐being of participants in the Midwest Evaluation of the Adult Functioning of Former Foster Youth (n = 603), a study of youth leaving out‐of‐home care in the USA, at the point where they have been ‘young adults’ for about 1 year. Although some of these young adults are in stable situations and either moving forward with their education or employed in promising jobs, more of them are having significant difficulties during the early stages of the transition to adulthood. Too many are neither employed nor in school, have children that they are not able to parent, suffer from persistent mental illness or substance use disorders, find themselves without basic necessities, become homeless, or end up involved with the criminal justice system. They are doing worse than other young adults across a number of important dimensions. Most of these young adults continue to maintain relations with members of their family of origin, with many finding themselves living with family at age 19. Importantly, those young people who chose to remain under the care and supervision of the child welfare system experienced better outcomes than those who either chose to or were forced to leave care.     

Working and caring for a disabled adopted child during a pandemic

Integrating work and family demands can be challenging for families caring for a child with one or more disabilities. The pandemic and its changes to work, schooling and service delivery potentially added to these challenges. This exploratory mixed methods study sought to understand how the pandemic affected adoptive parents' work–life fit and service use. A total of 200 participants responded to survey questions about parenting an adopted child with a disability prior to, and after, the onset of Covid-19. More than half of the parents (59.2%) reported that it was somewhat to very difficult to integrate both work and family demands. Parents with greater access to workplace flexibility and supportive supervisors had significantly less difficulties combining work and family. Families who reported more problems with accessing mental health services, special education and respite care reported significantly more challenges with work–family fit. Parents reported increased stress due to the pandemic changes, but many also shared positive changes such as more time for family. Online services were experienced as effective for some children and reduced time spent driving to appointments. Recommendations for workplace and social service practice and policy supporting adoptive parents of children with disabilities are discussed.     

智障儿童家长服务需求调查

家长在残疾儿童的康复过程中扮演着重要角色。为了解智障儿童家长在家属资源方面的需求,以便社工在工作中更好地为他们提供相关服务。本文以问卷调查的方式对广东省残疾人康复中心智障部32位在训智障儿童的家长进行了研究。结果发现多数家长对于家属资源服务表示感兴趣。他们对家属支援服务的服务内容、形式以及时间安排也表现出不同的需求。该研究将启发社工对现阶段所提供的家属资源服务内容进行反思和调整,并在未来的工作中进一步提供满足服务对象需求的相关服务。     

Families on the brink: the effectiveness of family support services

This paper presents findings from a study of the costs and effectiveness of family support services offered to 40 families with a high level of need, in two neighbouring local authorities in North Wales. It describes the level and type of services offered by different agencies in each of the authorities, estimates the costs of these services, and assesses outcomes for the families receiving them after three months. Information is also provided about families’ experience of the support they received, and the kind of help they would have liked. Parents’ well‐being and family functioning were found to improve over the intervention period in both authorities, although only to a limited extent. Improvements were greater among those who were living with partners, and less among families identified by social workers as having financial difficulties or problems with drug or alcohol abuse. Respondents who rated their problems as very severe showed less improvement. The pattern of service provision and the costs involved turned out to be similar in both authorities, so it was not possible to reach conclusions about the relationship between services and outcomes. However, a number of themes emerging from the data are discussed, including the role of day care services in supporting families with young children, the impact of poverty and deprivation on parents’ ability to provide good care for their children, and the importance of an interagency response to children's and parents’ needs. The article also includes a discussion of problems encountered in undertaking comparative outcomes‐based research and cost‐effectiveness analyses in the social welfare field.     

Family Policies in Germany and France: The Role of Enterprises and Social Partners

Although France and Germany are commonly classified as Bismarckian welfare regimes, they differ significantly in terms of family policy. For a long time, social and family policy in (West) Germany was focused on the male-breadwinner model of married couples. This was based on the expectation that women, in particular married women with children, would withdraw from the labour market permanently, or at least temporarily. Whereas care by mothers was massively subsidized by state family policy, the expansion of the childcare infrastructure was neglected and progressed only very slowly compared to the situation in many other countries of Europe. France, on the contrary, is one of the European countries where childcare services are particularly widespread, giving mothers the option to combine paid work and motherhood. Nevertheless, significant changes are happening in both countries. Concern over the demographic trends and low birth rates (in particular in Germany) have refocused attention on family policy in recent years. In Germany, it has now become a key field of debate and policy, and new actors have appeared on the scene. This article proposes to compare the latest developments in both countries, highlighting the contribution of enterprises and social partners to work–life balance, re-analysing the different types of familialism characterizing both countries.     

子女需求对城市家庭居住方式的影响

本文使用中国家庭动态跟踪调查2010年初访数据,着重分析了子女需求对城市家庭居住方式的影响。研究发现,子女需求是导致年轻夫妇与父母同住的重要原因,这种需求一方面表现在经济上,尤其是在住房上对父母的依赖;另一方面表现在需要父母分担家务和帮助照料小孩。所以,除了父母的养老需求,子女需求对城市家庭居住选择的影响也同样不容忽视。在现代化和人口流动的背景下,虽然城市家庭有核心化的趋势,但由于当代中国城市家庭依然发挥着不可替代的重要功能,大家庭在未来依然有继续存在的必要性。     

Family Dynamics and Individual Characteristics of Adult Children of Alcoholics

This study investigates differences in family dynamics and individual characteristics among: (a) adult children of alcoholics receiving professional and self-help recovery services; (b) adult children of alcoholics not receiving such recovery services; and (c) adults from families where there was an absence of substance abuse, domestic violence, incest, and chronic psychiatric or physical problems. Using discriminant analysis, two family variables (family competence and family cohesion) and three individual variables (individuation from parents, control issues expressed through feelings and problems with self-esteem) were identified as best discriminating between the three groups. Classification analysis revealed that although the identitied variables predicted a relatively high percentage of correct classification of the overall sample (69.05%), the most accurate prediction of group membership was at the extreme levels of family and individual functioning (either high or low). Implications for practice with alcoholic families and future research are discussed.     

The motives of foster parents, their family and work circumstances

Summary In foster care research the focus is generally placed on thechildren, not on the parents who perform the foster care. Inthis article the focus is on foster parents of 10-11 year-oldchildren. They were interviewed about their motives for becomingfoster parents, which were linked to their family and work circumstances.Among the 21 foster families in the study, four different butequally frequent reasons or motives for taking care of fosterchildren from the very beginning could be distinguished: relativeswho feel responsibility for a certain child; couples who wantchildren and do not think they can have children of their own;families where the mother wants to be at home taking care ofbiological as well as foster children instead of having unskilledemployed work outside the home; and parents with grown-up childrenwho want to fill the 'empty nest' by becoming foster parents- combined with a family business at home or close to home.Changing family and work patterns in Sweden do not seem to haveinfluenced foster families as much as families in general. Theworth of acquiring more knowledge about the families involvedin foster care of children and young people in order to improvefoster care and reduce breakdowns of care is discussed.     

The unknown soldiers of foster care: Foster care as loss for the foster parents’ own children

Abstract

This paper explores the effects of the foster care experience on foster parents’ biological children. In spite of having been accepted for over 40 years as the best form of residential care for most children and adolescents requiring alternative living arrangements, very little research has been done into the foster care experience. Almost nothing is known about the effects of foster care on either the foster family as a unit or its individual members, yet one of the major concerns foster parents present is the effect of the foster care experience on their own children. This concern leads many experienced foster families to leave foster care and many potential foster families to decide not to foster. This paper discusses the losses experienced by the children of foster parents.     

How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study

Adult mental health clinicians face a range of challenges that hinder their use of family‐focused practices when working with consumers who are parents. The purpose of this study was (a) to examine clinicians' experiences when working with parents and (b) identify strategies they found to be effective when working with parents. Eleven Australian mental health clinicians were recruited who regularly worked with consumers who are parents. Semistructured interviews were conducted within a qualitative paradigm and analysed using interpretative phenomenological analysis. Themes were identified which related to (a) managing sensitive parenting conversations, (b) making decisions about child safety in unclear or unpredictable situations, and (c) working with child protection services. Participants had developed strategies for managing the challenges of the first two practice issues and suggested organizational changes that could facilitate collaboration with child protection services. The findings highlight that the challenges of working with parents with mental health issues cannot be addressed with a one‐size‐fits‐all approach. Initiatives to facilitate the effective support of parents and their children need to be informed by contextual factors, including clinical practice.