Walk-in Together: A pilot study of a walk-in online family therapy intervention

Many Australians are requiring mental health care, including families, leading to long wait times in order to access support. Walk-in therapy reduces barriers to mental health support services by providing support at the time that families seek help. This paper presents a proof-of-concept study investigating the acceptability and short-term effectiveness of an online walk-in family therapy service, Walk-in Together (WIT). Part 1 of the paper describes the experiences of 44 family members from 22 families who presented to a public family therapy clinic for a virtual walk-in family therapy session. The session was conducted by a team of three experienced family therapists. Family members' experiences were sought pre-session, post-session, and at 6 weeks follow-up via survey and interview. Part 2 of the paper explores therapist perceptions (n = 7) of the WIT approach, through thematic analysis of semi-structured interview data. Post-session feedback showed 85% of family members found WIT to be helpful and 50% were optimistic about their future as a family after their WIT session. Six weeks post-session it was revealed that WIT supported planning for families in equipping them to move forward with 88% of family members reporting that they knew what to do after the session. All therapists uniformly experienced the model as offering a timely and beneficial service, suitable for diverse presentations and constellations of families. These preliminary results suggest the significant utility of this WIT intervention as a well-received and helpful service for families, who valued the easy access and rapid therapeutic response afforded by the online, walk-in delivery model. This proof-of-concept paper suggests the potential for further development and growth of WIT, as well as other mental health support services using a walk-in, telehealth model to meet the rising demand for therapeutic support for families in distress.     

Latino Families with a Child with Prader–Willi Syndrome: Exploring Needs for Support

Prader–Willi syndrome (PWS) is a complex, genetically based disorder; caring for a family member with a disability such as PWS brings significant challenges to the whole family. However, no research has been conducted focusing on the impact of PWS in the dynamics of Latino families. This qualitative study explored the challenges and need for support services among Latino families of children with PWS. Findings of the study suggest the need for support services geared toward the whole family unit to help members cope with daily challenges at home.     

The child in family services: expanding child abuse prevention

Child welfare concerns have drifted to an inappropriate focus on crisis intervention and a punitive approach to child protection intervention at the expense of community-based preventive child welfare programs. Recent attempts to divert cases from the child protection system through differentiated response mechanisms have been criticised for failing to provide access to relevant services or preventing vulnerable families from re-entering the child protection process. A tension inherent in providing both child protection and family support within the one agency is also identified as a barrier to effective service delivery. This paper discusses the value of the UK Children in Need approach as a model for enhancing support to children and families outside the statutory child protection system. Information from an evaluation of a trial implementation of the UK Children in Need approach in Victoria is used to discuss the implications for policy and practice of placing responsibility for coordinating a response based on the needs of children and their families within family support services.     

Informal caregiving for elders in Sweden: an analysis of current policy developments

In Sweden, care of elderly people is a public responsibility. There are comprehensive public policies and programs providing health care, social services, pensions, and other forms of social insurance. Even so, families are still the major providers of care for older people. In the 1990s, the family was "rediscovered" regarding eldercare in Sweden. New policies and legislative changes were promoted to support family caregivers. The development of services and support for caregivers at the municipal level has been stimulated through the use of national grants. As a result, family caregivers have received more recognition and are now more visible. However, the "Swedish model" of publicly financed services and universal care has difficulty addressing caregivers. Reductions in institutional care and cutbacks in public services have had negative repercussions for caregivers and may explain why research shows that family caregiving is expanding. At the same time, a growing "caregivers movement" is lobbying local and national governments to provide more easily accessible, flexible, and tailored support. In 2009, the Swedish Parliament passed a new law that states: "Municipalities are obliged to offer support to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities." The question is whether the new legislation represents a paradigm shift from a welfare system focused on the individual to a more family-oriented system. If so, what are the driving forces, motives, and consequences of this development for the different stakeholders? This will be the starting point for a policy analysis of current developments in family caregiving of elderly people in Sweden.     

Characterizing the systems of support for families of children with disabilities: A review of the literature

ABSTRACT

During early childhood, children require major support that is tailored toward their specific needs. For children with disabilities, families play a crucial part in providing the needed services. However, families often lack the knowledge, resources, and skills that would help them in overcoming challenges that arise while raising a child with disability. Although much research has focused on defining the needs of families with children with disabilities and the impact of disability on the family system, many questions remain. A comprehensive perspective is needed to identify the types of support families provide to the child with a disability, the impact of providing that support on family members, the support systems that are available to families, and the impact of support on society. This review consolidates the empirical research to date on family support during early childhood and outlines areas of research that need further exploration.     

A preventive services program model for preserving and supporting families over time

Selected findings from a three-year study are reported regarding a prospective sample of 189 families served by the Center for Family Life's preventive services program and the nature and results of the services the families received. The program combines elements of both family preservation and family support services to provide a comprehensive, individualized response to families in need and prevent the unnecessary placement of children in care. Four program elements correspond with those typically identified as characterizing family preservation programs, and three key program elements differentiate the Center's approach from other family preservation programs. These latter characteristics are more typically found in family support programs and address limitations of current family preservation programs as identified in the literature.     

Challenges of Interdisciplinary Collaboration

Abstract

The realities of the 1990s, which include reduced funding and resources, the public's impatience with bureaucratic rigidity, and the empowerment of families who want timely and appropriate services, have created a favorable climate for collaborative, interdisciplinary practice. Collaborative, family-centered practice models are being promoted by family/child advocates and professionals. Yet child and family services, for the most part, continue to be provided in traditional ways using individual treatment and categorical services. However, federal child mental health funding is supporting community-wide, collaborative practice in twenty-one sites scattered across the United States. One site, in rural northeastern North Carolina, is unique as it includes a graduate-level, interdisciplinary academic component [East Carolina University's (ECU) Social Sciences Training Consortium (SSTC)] to train and support service providers and families, and to prepare master's level graduates to work in such innovative programs. Called PEN-PAL [an acronym for Pitt-Edgecombe-Nash (three NC counties) Public Academic Liaison] this university/interagency collaborative effort works in partnership with families to coordinate public and community services into a seamless system of care for children with severe emotional disturbances. This article is based upon a qualitative study of SSTC faculty members, and it chronicles the successes and difficulties encountered by faculty in the first year of a five-year collaborative process.     

Supporting family life: A survey of homeless shelters

Survey data from a national sample of homeless family shelters (N=59)were analyzed to describe the family support programming available to residents. Data were reported on facility and resident characteristics and family support programming, as well as on facility admission criteria and program participation requirements. Four independent variables (length of stay, shelter capacity, sponsorship, and program philosophy) were examined for their relationship to the family-oriented services offered. Facilities sheltered an average of 17 families, with a range of 2–200; the average length of stay for families was slightly over 5 months. Regarding family programming, services of an educational nature were more popular than those focused on providing support or therapy/intervention; services to parents to further adult development were more often offered than those either directed to parents in their parenting roles or to the family as a unit. Virtually all shelters (98%) applied eligibility criteria to families seeking admission. The most common reasons for exclusion were active drug (86%) and alcohol (83%) abuse by a family member; 40% also refused acceptance to families with adolescent males. Seventy-eight percent of facilities mandated participation in some support services. Smaller shelters operated with greater numbers of exclusions (¯x=5.98773; p<.05);larger shelters had higher percentages of mandatory family programming (¯x= 9.21823; p<.06).These findings shed light on shelter directors' beliefs about the etiology of family homelessness and proper steps to solve the problem.     

Family support for the elderly in Korea: continuity, change, future directions, and cross-cultural concerns.

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Disadvantage and Discrimination Compounded: the experience of Pakistani and Bangladeshi parents of disabled children in the UK

This paper discusses a qualitative and quantitative study of the circumstances of 20 Pakistani and Bangladeshi families with one or more severely disabled children living in Birmingham, England. Parents and other adult carers were interviewed using a combination of structured questionnaires and a semi-structured interview schedule focusing on the families' material circumstances, their use of formal services, informal care arrangements, and aspects of the parents' social and psychological well-being. The study suggests that previous national surveys of disabled families may have under-estimated the extent of material disadvantage, while it confirms that health and social care professionals should not assume that Pakistani and Bangladeshi parents have recourse to high levels of extended family support. The combination of disadvantaged circumstances and difficulties in securing access to appropriate services, which are found for the majority of families with a disabled child, was particularly acute for these ethnic minority families, suggesting the additional dimension of institutional racism.     

“Some of My Children Are Worth More Than Others”: Perceptions of Nonresidential Fathers with Second Families as to the Fairness of the Australian Child Support Agency's Handling of First Family Child Support Financial Arrangements

One in three Australian marriages end in divorce, and over half of such divorces involve children. Research indicates that men tend to repartner within 1 to 2 years of a divorce and women within 3 to 5 years. A significant issue for repartnered men is the provision of financial support for children from both their first and second families. Although only 6% of all Australian first family children spend near/equal time (shared care) after divorce with both parents, fathers in Australia are mandated under child support legislation to provide financial support for their first family children, whether they reside with them or not. However, it is argued by this study's nonresidential fathers that the Child Support Agency, when considering the level of financial support for first family children, tends to overlook the needs of second family children, thus creating an advantaged and disadvantaged set of siblings. This finding is reviewed through a distributive justice theory lens. Finally, some future directions for research aimed at exploring the impact of Child Support Legislation on second families are suggested.     

Family preservation: a potential not yet realized

When they received widespread promotion and support beginning in the 1980s, family preservation services seemed to hold much promise for the child welfare field, and for the lives of families and children. Unfortunately, this promise has never been fully realized throughout the United States. This article traces the recent history of family preservation services, examines some of the reasons why efforts to implement family preservation services have been less than completely successful, and proposes a strategy for ensuring that these services reach their potential in the future.     

Engaging with Disability Services: Experiences of Families from Chinese Backgrounds in Sydney

People from Chinese backgrounds remain underrepresented in disability service use. This paper explores family experiences of using child disability support services to understand how migration and their cultural expectations about disability and service affect the way they use services. Qualitative semistructured interviews were conducted with 13 family carers in Sydney. They were striving to gain good support for their child from formal services. However, most of them were reluctant to express any dissatisfaction to service providers, which meant that assertively requesting different support was difficult and culturally inappropriate. In response, service providers can design nonconfrontational ways to elicit this vital information and support families to gain experience tackling conflict.     

‘Like a fish in a bowl’: parents' perceptions of child protection services

This research involved a small qualitative study focused on family experiences of child protection practice, commissioned as part of a Best Value review of child protection services in a large rural Midlands local authority. Qualitative interviews were undertaken with 18 families who had received child protection services. Findings were mixed in relation to perceived helpfulness of the processes of child protection interventions, with 50% of families reporting some positive bene?t and 22% reporting that such interventions had caused them harm. From the families' perspectives, factors that are associated with positive and negative outcomes are outlined. These include the availability of preventive services, crisis support, respite care, actual provision of services speci?ed in protection plans and an engaging style of practitioners. Conclusions emphasize the value of research focused on family perceptions of services as an important contribution to quality control and service development in child protection service provision. Copyright © 2004 John Wiley & Sons, Ltd.     

Family Support for the Elderly in Korea

Abstract

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Family Caregivers for Seniors in Rural Areas

In this article, the demographic characteristics of family caregivers for seniors in rural communities are assessed to examine whether their circumstances could facilitate or impede their well-being. Services available in rural communities for family members providing ongoing care to frail seniors is examined, particularly those that provide health and social services. How families access these services and whether there are specific barriers in service provision are analyzed based on current social work practice and the research literature. Trends for future services are identified as well as whether these trends support new roles for social workers in rural settings.     

Family support for the elderly in China: issues and challenges

With the introduction of economic reforms, families in China are challenged by a variety of family-related problems. Demographic and social changes are affecting both the capacity and willingness of the family to provide care for the elderly. The Chinese Government is aware of the importance of the family in the welfare of its citizens, and has promulgated a series of laws and regulations prescribing family obligations. Yet formal services supporting families are extremely underdeveloped, and it is urgent that the government formulate an effective policy to facilitate, support, and maximize family care.     

Post-adoption needs of families adopting children with developmental disabilities

The post-adoption service use and needs of 125 families who had adopted children with developmental disabilities were examined using a structured mail questionnaire. Although satisfaction with services used was generally high, many families did not have access to basic family support services such as respite care, life planning and support groups. Income was the only demographic variable which correlated with service need. Middle income families (mean = $30,000 to $34,999) were more likely to need support groups and babysitting for other children than either lower or higher income groups. Of particular note in this study is the relatively high incidence of transracial adoptions. Thirty-one percent of the sample had adopted children of a different race than the family. The implications of the findings and service recommendations are discussed.     

Multi-family psychoeducation groups in the treatment of children with mood disorders

This study examined the impact of adjunctive multi-family psychoeducation groups (MFPG) on mood-disordered children aged 8 to 11 and their families. Participants were 35 children and 47 parents from families randomly assigned to either immediate MFPG plus treatment as usual (n = 18) or a 6-month wait-list condition plus treatment as usual (n = 17). At the 6 month follow up, immediate treatment families reported: Increased parental knowledge about childhood mood symptoms; increased positive family interactions as reported by the parent; increased perceptions of parental support as reported by children; and increased utilization of appropriate services by families. Expected impact on decreasing negative family interactions was not found. Results are largely consistent with hypothesized findings and support the need to further investigate the adjunctive role of psychoeducation in the treatment of childhood mood disorders.