Parent Management Training, Relationships with Agency Staff, and Child Mental Health: Urban Foster Parents' Perspectives

Many foster parents are ill prepared to meet the behavioral needs of children placed in their homes. Research suggests they lack training in evidence-based behavioral interventions and feel unsupported by child welfare professionals. Given the complex needs of foster children and increased rates of placement disruption for foster children with behavior problems, implementation of effective interventions is essential. However, little is known about foster parents' receptivity to these types of interventions. In this qualitative study, we examine urban foster parents' perceptions of the specific elements of parent management training (PMT), an evidence-based treatment for disruptive behaviors that teaches parents to improve desired behaviors and decrease oppositional behaviors by rewarding positive behaviors (positive reinforcement) and responding to negative behaviors with mild, consistent punishments such as timeout or a privilege removal. We present data from four focus groups (N = 38). While the questions focused on parent's perceptions of PMT, responses often related to parent interactions with agency staff. Four strong themes emerged from the data. First, foster parents discussed a need for more support and training in how to address children's behaviors, but also had concerns that some PMT discipline techniques would be ineffective based on their past experiences with foster children. Second, they described how staff communication skills and allegations of child abuse could affect parents' motivation to continue fostering. Third, they expressed a need for more detailed information about children's histories and visits with biological families as the lack of information contributed to difficulty in meeting foster children's needs. They suggested that joint training of foster parents and staff in the intervention could improve their ability to work together to support the child's positive behaviors. Finally, parents reported little involvement in child mental health services and doubted the effectiveness of the mental health services their foster children received.     

Better practices in parent engagement: lessons from the USA and England

This paper undertakes an international comparison of parent engagement in the USA and England. Research from both countries is reviewed to establish the extent to which parent engagement is achieving the benefit of an improved fit between need and services and what, if any, differences exist between the experiences of parents in the USA and England. Despite some unique differences, research from both countries identifies similar experiences among parents. Those studies indicate that parent engagement is not yet contributing to the provision of services that are more timely, appropriate, or adequate in meeting parent need. The barriers to achieving a better fit between needs and services are explored and system-wide issues that limit the effectiveness of engagement with parents are discussed. The paper presents the Munro Review of Child Protection in England as a catalyst for change in improving the child welfare system's approach to parent engagement and establishing a better fit between needs and services. Consideration of the applicability of the Munro Review findings to the USA child welfare system or replication of such a review is proposed.     

Peer mentoring services,opportunities, and outcomes for child welfare families with substance use disorders

Peer recovery support services (PRSS) in child welfare are being provided by peer mentors in sustained recovery from substance use disorders (SUD) to parents with acute SUD. Previous retrospective interviews demonstrate that peer mentors engage parents in family-centered systems of care through relationships and empowerment. However, the specific profile of services provided is unknown. Personnel challenges and opportunities for persons in recovery serving as peer mentors are described in the literature without understanding the frequency of both. As enthusiasm for hiring peer mentors grows, it is important to understand the specific services provided, the risks and opportunities associated with hiring individuals in recovery, and the impact of mentor services on outcomes. This knowledge can assist in developing training, implementation guides, policies, job expectations, and program evaluation strategies. This is a prospective study of 28 family mentors providing PRSS services to 783 families with child maltreatment and parental SUD over 8 years in a family-centered integrated program with SUD treatment providers. We describe mentor services overall, during the early engagement period, in rural and urban settings, and test the association between services and child/parent unification status at case closure; we identify the proportion of peer mentors that experienced employment challenges and career advancement opportunities. Results demonstrate the complexity of service provision overall and in differing contexts. Face to face visits with children were associated with greater likelihood of parent/child unification at case closure and 64.3% of peer mentors experienced career advancement opportunities. The implications of these findings are discussed.     

A qualitative data analysis: family victim advocates in child advocacy centers

ABSTRACT

Family victim advocates in child advocacy centers provide a valuable resource to children and parents involved in child abuse investigations. This work requires that family victim advocates be knowledgeable in such areas as child development, crisis intervention, community resources, family relationships, child welfare and criminal justice systems. Because family victim advocates provide essential services to parents and caregivers, the role requires ongoing training and education to remain current on the ever-changing complexities of working with not only the children and families but also the criminal and child protection systems responsible for investigating these cases. The current study reports the findings from a nationwide survey of family victim advocates employed in child advocacy centers related to their motivation for doing the work as well as their perceptions of their training and potential training needs. A group of doctoral students comprised the research team and worked collaboratively under the supervision of university faculty to conduct the qualitative data analysis. The findings describe the characteristics and motivations of family victim advocates working in child advocacy centers and emphasize the need for more advanced trainings that focus on skill-building and strengths-based practices utilized to support children and parents in child abuse cases.     

Knowledge,Attitude and Practice of Child Sexual Abuse Prevention among Parents of Children with Hearing Loss: A Pilot Study in Beijing and Hebei Province,China

ABSTRACT

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls’ parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice.     

Partnering with parents to prevent childhood sexual abuse

Although research demonstrates that child‐focused sexual abuse prevention programmes can teach children personal safety knowledge and skills, childhood sexual abuse (CSA) prevention programmes that involve parents have a number of distinct advantages. The more knowledge parents have about CSA, the greater likelihood they can create safer environments for their children and thus prevent the occurrence of sexual exploitation. Research has demonstrated that parents lack crucial information about CSA and can benefit from even brief educational efforts. This paper will identify potential barriers to participation and offer practical suggestions for enhancing both recruitment and retention rates. Recommendations for parent education programmes are offered, including improving parents' confidence and skills in educating their children about CSA, providing them with parent‐friendly materials to use and developing Internet applications. Copyright © 2010 John Wiley & Sons, Ltd.     

Parent perspectives on adoption preparation: Findings from the Modern Adoptive Families project

Preparing prospective adoptive parents for receiving a child into their family is an important task for child and family professionals. This study uses data from the recent Modern Adoptive Families survey to understand parent perspectives on their preparation for adoption. Logistic regression (n = 917) and qualitative thematic analysis of adoptive parents' comments about their adoption preparation were conducted to understand aspects of the preparatory experience that were satisfactory (n = 623) or dissatisfactory (n = 283). Child emotional and behavioral problems significantly predicted parent dissatisfaction with adoption preparation. Major themes for satisfactory aspects of preadoption services included receiving information about adoption in general and, more specifically, about clinical and special populations, and parenting tools and strategies. In addition, parents identified opportunities to connect with others touched by adoption and access to specialized post-adoption services as helpful. Conversely, parents expressed dissatisfaction when information was lacking or withheld, when they had quality concerns with the worker or agency, and when there was a dearth of services and supports following adoption. Implications of these findings include the need for adoption mental health competent training for adoption professionals to better support families preparing for or experiencing adoption.     

Behaviors and Strategies Employed in Parental Alienation

Abstract

A survey study was conducted of adults who self reported being targets of parental alienation. Three research questions were addressed: (1) What alienating strategies were identified by the targeted parents and to what extent were these behaviors consistent with those identified by adult children of PAS? (2) Was gender of the targeted parent associated with number and/or type of strategy identified? And (3) What child and parent characteristics were associated with level of PAS (mild, moderate, severe) as described by the targeted parents? Ninety-seven individuals completed a written survey. One section of the survey asked participants to list every type of behavior that they believed the alienating parent used to effectuate the alienation. From prior research and review of the responses, a list of possible strategies was developed. The 1,300 actions described by the 97 participants were independently coded. Results revealed 66 types of strategies, 11 mentioned by at least 20% of the sample. There was considerable but not complete overlap in the strategies identified by the targeted parents with those described by adult children (from another study). There were no statistical differences in the number or type of strategy mentioned based on the gender of the targeted parent or the gender of the target child. Level of severity of PAS (mild, moderate, severe) as perceived by the targeted parent was associated with age and gender of the target child, with girls and older children being more likely to be reported as more severely alienated. These results provide a systematic examination of the different types of alienation strategies known to targeted parents and as such they offer several avenues for clinical interventions and future research.     

Foster parent perceptions of placement breakdown

The purpose of the study was to describe the perceived causes of placement breakdown by foster parents. Sixty-three foster parents from fifty families were asked to describe their challenges in response to the following question: “What would make you consider ending a foster placement”? The responses to this question were analyzed using multidimensional scaling and cluster analysis, to yield nine themes. Foster parents indicated that they would consider ending a placement if there was a danger to their family, if the child could not adapt to the home or if they could not handle the child's behavior. Participants reported that the complex health needs of a foster child, problems dealing with the foster agency, and several unsuccessful attempts to make the placement work would cause a placement to breakdown. Foster parents also indicated that they would consider ending a placement if their personal circumstances changed, their own health deteriorated, or there was a lack of appropriate external support in place. The results of the study point to gaps in the research on violence in general foster care, foster parent perceptions of contributions to a foster child's transition back to his or her birth family, and the process of foster parent decision-making in cases of placement breakdown.     

School counsellors' perceptions of mandatory reporter training and mandatory reporting experiences

The purpose of this study was to examine child abuse reporting by a national sample of school counsellors in the United States. The qualitative results from a large mixed methods study incorporating both quantitative and qualitative strands are presented. Participants were asked to comment on past child abuse training, noting the areas of training they found most beneficial and areas where they desired additional training. Participants were also afforded the opportunity to make any general comments regarding their perceptions of the current mandatory reporting legislation and their experiences of reporting child abuse. Results showed that while many school counsellors felt past training on mandatory reporting legislation and identifying types of abuse was helpful, they identified a need for additional training in identifying emotional and sexual abuse, and supervisory neglect (i.e. lack of supervision by a parent or caretaker producing potential injury or harm to the child). They also desired more training regarding working with children and families affected by child abuse. Four themes emerged from the open question. The first theme illuminated concerns regarding the effectiveness of the mandatory reporting process while the second theme was equally negative, with counsellors sharing many frustrations about their working relationship with child protection services. Additional themes related to their reporting experiences and specific challenges embedded in the school context, such as dealing with parents following a report, difficulty getting adolescent reports investigated and working with school personnel to ensure that reporting responsibilities were understood and followed. Copyright. © 2009 John Wiley & Sons, Ltd.     

Use of a Parent Management Training Intervention with Urban Foster Parents: A Pilot Study

The development of effective interventions for foster children with behavior problems is essential given the consequences of behavior problems for children's placement stability and permanency outcomes. This article presents findings from a pilot study of an intervention providing parent management training (PMT) and support to foster parents in groups and home visits. The intervention was an adaptation of the KEEP (Keeping Foster Parents Trained and Supported) group intervention, provided in a large urban child welfare agency serving predominantly African American foster parents. The study used an intent-to-treat design, with 25 foster parents of 31 children (ages 4-12) in specialized foster care assigned to either an intervention or treatment as usual control group. Longitudinal outcomes were analyzed using random effect regression models. Over time, children's behavior problems were significantly lower in the intervention group relative to the control group, and the effect of the intervention was partially mediated by parents' understanding of how to appropriately use the intervention parenting skills. These results provide support for the effectiveness of KEEP with urban foster children with significant behavior problems.     

Meeting the parenting skills needs of neglectful families by training child welfare workers as educators

A training program was devised for selected child welfare workers to conduct parent groups in the Missouri Neglect Demonstration Project. Welfare workers were trained to conduct parent groups that focused on parenting skills, self-advocacy, and social and economic resources. In contrast to case manager referrals, the workshops provided education directly and helped parents to develop resources. One of the goals was to have staff and parents collaborate to improve referral services and resources. The importance of this type of program was demonstrated by a literature review of parent trainings which found that: (a) few programs specifically addressed child neglect; (b) outcome evaluations of programs were scarce; and (c) a national extension study supported topics chosen.     

Design Imperatives to Enhance Evidence-Based Interventions with Persuasive Technology: A Case Scenario in Preventing Child Maltreatment

ABSTRACT

This article examines how current thinking in persuasive technologies may be applied to evidence-based therapeutic interventions through a planned and multidisciplinary design process. Design steps identified in the human services and the design sciences are merged to generate six design imperatives. The need for human service knowledge to inform design is discussed in each design imperative. A case scenario using Healthy Families America (HFA), a broadly implemented child abuse and neglect prevention program, is presented as illustrative. The final design imperative argues for continuous attention to ethics across all disciplines. The design imperatives provide an initial framework for optimizing the development of persuasive technology applications in the human services.     

Different Storks for Different Folks

SUMMARY

When gay and lesbian couples decide to become parents, they are unique as a group in always requiring the involvement of a facilitating other: a donor, surrogate, or (in the case of adopted or foster children) birth parents. This clinical paper explores common psychological and social challenges gay and lesbian couples face when using alternative reproductive technologies to attain parenthood. Between the wish and the actuality of being at home with their baby, gay and lesbian parents travel a long and winding road of choices and chances taken. The parenting partners often consist of one biological and one non-biological parent. Issues of psychological/emotional parenthood as opposed to merely biological parenthood (including assumptions of potential inequality or differential legitimacy) must be reconciled in the minds, couple relationships, family of origin relationships, and friendship support systems of the partners before and after the child's birth. The family must also navigate others' questions and assumptions as they venture ever further beyond their intimate circle and as their growing child forms relationships with peers. Specific guidelines are offered for helping couples surmount these psychosocial challenges.     

Parenting a Child With an Autism Spectrum Disorder: Public Perceptions and Parental Conceptualizations

In the middle part of the 20th century, parents were frequently blamed for causing autism. Although this idea is no longer prevalent in professional circles, this qualitative study indicates that parents still experience blame from community members and extended family. Eleven parents of children with autism participated in two focus groups. This qualitative study examined themes of parent blame as well as parents' own conceptualizations of autism. Results indicate that parents experienced blame for their children's autism-related behavior from the public and extended family, but most parents viewed the child with autism in positive ways.     

Children’s Mental Health Providers’ Perceptions of Mental Health Literacy Among Parents and Caregivers

Mental health disorders are prevalent among children, yet many do not receive treatment. Parents and caregivers play a vital role in recognizing mental health disorders in children and accessing treatment. But a substantial number of parents lack essential knowledge of children’s mental health disorders, including risk factors, symptom recognition, and treatment options. Little focus has been given to parents in the children’s mental health literacy literature. The purpose of this article is to begin filling that gap by using a survey to describe the perceptions of child and family mental health providers’ perceptions regarding the amount, accuracy, and origin of mental health literacy in the parents of the children they treat. The impact of those perceptions on the work of providers is also explored. Eighty-seven mental health providers completed a survey to assess their perceptions of parent mental health literacy in the area of children’s mental health. Providers perceived parent mental health literacy as low, inaccurate, and inconsistent. In addition, providers indicated that parents rely on informal sources of support, such as friends and family for information about children’s mental health. Implications for social work researchers, practitioners, and the children and families they serve are discussed.     

Child Welfare Professionals’ Experiences in Engaging Fathers in Services

The purpose of this exploratory focus group study was to examine child welfare professionals’ (n = 22) experiences with and perspectives towards working with fathers. The six themes that emerged from the thematic analysis contrasted sharply with earlier research findings and indicated that child welfare professionals skillfully engage fathers and that some fathers trust the system and are motivated to be involved. The findings revealed insights about foster fathers and working with foster parents. Unique regional issues also emerged as a factor that affect fathers and families. Recommendations for designing training, especially in areas with limited fatherhood specific services are provided.     

Remaining home: Well-being outcomes and co-occurring parental substance use following a maltreatment investigation in middle childhood

PurposeThe purpose of the study is to understand differences in child well-being related to parental substance use among children ages 6–12 who were investigated for maltreatment but not removed from their homes. Children with a substance-using parent in the home are compared to those without a substance-using parent in the home.MethodsLongitudinal data from waves 1 and 3 of the second National Study of Child and Adolescent Well-Being (NSCAW II) are used. NSCAW II is a national sample of families with children and youth aged birth to 17.5 investigated by child protective services (CPS). A subset of the data (analyzed with domain analysis methods) is used for this study (n = 575). Eight well-being outcomes from four domains (cognitive development, physical health, psychological/behavioral development and social/emotional competence) are analyzed.FindingsWe hypothesized that (among children investigated for maltreatment and not removed from home) children whose parents used substances would exhibit lower mean levels of well-being at thirty-six months follow-up compared to those whose parents did not use. Unexpectedly, we found no significant differences in well-being levels between children with parents in the home using substances and those without.ConclusionsChildren with substance-using parents may be able to remain at home over an extended period after investigation, while maintaining well-being levels similar to children at home with parents not using substances. If an effective safety plan can be put in place, this option may provide a path to maintaining safety, permanency and well-being for such children without placement in out-of-home care.