Services for emotionally disturbed children and their families: a personal view

SUMMARY. The invitation to contribute to Children & Society coincided with the writer's official retirement from child psychiatric practice. The development of services, clinical, training, teaching, and research has been an ever present challenge throughout. With just enough sense of ‘distance’ to aspire to a feeling of perspective, but not jet too remote from the scene, the author sets out a personal view of the services for emotionally disturbed children and their families. While progress is painfully slow he concludes that there is sufficient goodwill to achieve some real improvements.     

Contemporary discourses on children and parenting in Norway: Norwegian Child Welfare Services meets immigrant families

Discourses on children and what is considered to be proper parenting have been accentuated by the processes of globalization. In Norway, we study current discourses on children and parenting, based on a particular case: Norwegian Child Welfare Services' interaction with and intervention in immigrant families with children. We use a discursive analytical framework to analyse a sample of 80 newspaper texts, reflecting on and debating this allegedly problematic meeting. The texts are derived from regional and country-wide Norwegian newspapers in the period 1 January 2011 to 30 April 2013. Distinct discourses located in the texts concerned: (1) No-tolerance for parenting practices implying violence and force; (2) Every child is a subject of individual – and equal – rights; (3) Good parenting is child-focused and dialogue based and (4) Norwegian Child Welfare Services – authoritative as well as contentious in family matters. The discourses indicate the presence of two important subject positions, first, the child as the pivot. This implies that children are given a superior moral status, and are to enjoy human dignity and values such as individuality, equality and justice, individual rights and an obligation for the state to oversee and ensure this position also for the child. The other important subject position concerns parents as guarantors for children developing proper skills. This compels processes toward standardization and homogenization of parenting which positions some groups of parents as deficient.     

Resource use of rural low-income families caring for children with disabilities

The Personal Responsibility Work Opportunity Reconciliation Act, Pub.L. 104-193 (PRWORA) was passed creating the Temporary Assistance to Needy Families (TANF) program. Since the passage of PRWORA, many families were able to leave the welfare rolls while those remaining on welfare were likely composed of families facing barriers to leaving, such as caring for children with disabilities. This project addresses the gaps in knowledge regarding low-income families caring for children with disabilities by conducting qualitative research investigating the resources used by these families to find and keep employment and child care. The study used a sample from a research project entitled ‘Rural Families Speak’ and examined the data of 26 families caring for children with disabilities. Analysis resulted in policy recommendations for increasing the efficacy of the programs designed to help these families.     

Center-based childcare use by Hispanic families: Reasons and predictors

This study explored the reasons and factors associated with childcare use for Hispanic children of preschool age with working and nonworking mothers. National Household Education Survey/Early Childhood Program Participation 2005 data were used. The data suggested that use of center-based childcare is more frequent than use of parental care, relative care, or nonrelative care. In general, family poverty status, mother's education, household composition, mother's work status, and acculturation are all significant predictors of center-based childcare use. The importance of the educational and pragmatic characteristics of childcare plays a significant role in childcare selection for parents of Hispanic preschool-age children. Mothers who put greater value on socialization are more likely and mothers who put greater value on location and reliability are less likely to use a center-based childcare. Nevertheless, the relationship between family characteristics and center-based childcare use, and the relationship between the importance of childcare characteristics and center-based childcare use, depends on the mother's working status.     

Contact with birth family in intercountry adoptions: Comparing families headed by sexual minority and heterosexual parents

Contact between adoptive families and birth families in the context of intercountry adoption, as well as adoption by sexual minorities (e.g., lesbians and gay men), represent understudied topics. In the current study, we examine the extent and type of contact with birth family in intercountry adoptive families headed by heterosexual and sexual minority parents. Data were drawn from the Modern Adoptive Families project, a nationwide, non-random survey of adoptive parents' beliefs and experiences that was conducted from 2012 to 2013. The current sample consisted of 479 families headed by heterosexual parents (H) and 38 families headed by sexual minority women (SM) whose oldest adopted child was younger than 18 years of age and who had been placed from another country. Although no family type difference was found in contact with birth family prior to or at the time of placement (H = 9.6%; SM = 13.2%), sexual minority respondents reported a higher level of contact with one or more members of their children”s birth families following adoptive placement than did heterosexual respondents (SM = 28.9%; H = 14.4%), as well as currently (SM = 21.1%; H 9.8%). They also reported more contact with their children”s birth mothers than did heterosexual parents, although no family type differences were found for contact with other birth family members. Policy and practice implications are discussed.     

Contact with birth family in adoptive families headed by lesbian,gay male,and heterosexual parents

In this study, we examined the extent and type of contact with birth family in adoptive families headed by sexual minority and heterosexual parents prior to or at the time of placement, following placement, and currently. Data were drawn from the Modern Adoptive Families project, a nationwide, non-random survey of adoptive parents' beliefs and experiences that was conducted from 2012 to 2013. The current sample consisted of 671 families headed by heterosexual parents, 111 families headed by lesbian parents, and 98 families headed by gay male parents whose oldest adopted child was less than 18 years old and who was placed domestically either from the public child welfare system or from a private agency or independent adoption facilitator. For child welfare adoptions, sexual minority parents reported higher levels of contact and tended to have more positive relationships with birth family compared to heterosexual parents. Fewer differences by family type were found for private agency adoptions. Higher rates of contact and more positive relationships with birth family were found for private domestic placements compared to those from foster care. Secondary analyses suggest that family demographic and adoption placement differences between sexual minority- and heterosexual-parent families do not account for family type differences in contact with birth family. Policy and practice implications are discussed.     

Healthy children in families affected by AIDS: Epidemiological and psychosocial considerations

Traditional means of conceptualizing the psychosocial impact of AIDS have emphasized infected individuals out of their natural context AIDS occurs not simply within hospitals but within families. A secondary morbidity occurs within a family system when one of its members is infected. Clinical experience suggests that non-infected children within families with AIDS are at significant risk for poor developmental outcomes as a consequence of the skewing of familial resources. Children living in families who have a member infected by HIV are impacted by isues such as stigma, isolation, abandonment, and death. This article explores the epidemiology of this child population and risk factors that render them vulnerable. Social workers are in a unique position to identify and serve these children in such diverse settings as schools, welfare agencies, and hospitals. Suggested interventions based on the developmental stage of the child are discussed as are implications for policy formation and program development.     

Hierarchical relationship development: parents and children

Child growth and development occur in hierarchical relationships. In our attempt to work more collaboratively, family therapists have neglected to work toward developing theory that guides our work in such hierarchical relationships. This article describes a method for understanding child and relational growth. It builds on Wynne's (1984) epigenetic model of relational systems by integrating his model of family development with Bateson's (1958) concepts of complementarity and symmetry. Wynne's model defines a process for understanding the stages of relationship development, and Bateson articulates the process of change within a relationship. Utilizing principles from both theorists, this paper proposes that parent-child complementary relationships mature through Wynne's developmental stages via symmetrical struggles, and that these symmetrical struggles are necessary ingredients in the development of the relationships as well as of the individuals within those relationships.     

Relative foster parents of HIV-affected children

The HIV epidemic is one of the reasons for an increase in relative foster care. Most children of HIV-infected parents are not infected, but both the children and their caregivers are affected by the parent's illness. Twenty-eight caregivers participated in an exploratory, qualitative study of the permanency planning needs of HIV-affected relative foster parents. Of the caregivers, 17 disclosed that the foster child's parent was HIV-infected; 11 caregivers did not report HIV infection in the immediate family. HIV-affected caregivers' greatest need was a more adequate response from social workers and therapy services for the children; nonaffected caregivers needed financial assistance most. More HIV-affected caregivers were considering permanency than nonaffected caregivers. Child welfare workers and relative foster parents need training on HIV's effect on the families so that appropriate services can be accessed as early as possible.     

Services for maltreated children: variations by maltreatment characteristics

Mental health services were the most frequently recommended service for maltreated children known to a child protective service agency, but more than one-fourth of the children with serious behavioral problems did not receive referrals for such services. Children with long histories of maltreatment were more likely to be referred for some services, especially out-of-home care. Gaps in services remain, underscoring a need for research focused on the need for interventions targeted to maltreated children involved with child protective service agencies.     

Advocating for children of separating parents

This article draws upon the author's lay experiences of helping two sets of divorcing parents to retain contact and meaningful relationships between their young children and their non-resident fathers. It argues that the failure to take account of past parenting practices in divorce proceedings, to grant children party status and to make independent representation available to them, and to offer child-centred services to help parents to practise shared parenting post-separation, may contribute to the widespread loss of contact between children and their non-resident parents, particularly fathers. The Family Law Act 1996 promises little change.     

Psychological stress in adoptive parents of special-needs children

This article focuses on the nature and extent of parental stress among adoptive parents of special-needs children. In-depth face-to-face interviews of adoptive parents of 35 children were conducted, on average, four months postplacement (but before adoption). One-year follow-up interviews were conducted with parents of 15 (43%) of these children. Qualitative and quantitative data were collected, including parenting stress scores. Results indicated higher than average levels of stress, particularly on subscales related to parent-child dysfunctional interactions and to raising a difficult child. Increased stress levels were associated with poorer family adjustment and with higher levels of child behavior problems. Stress levels remained mostly unchanged over the year. Responses to open-ended questions identified five stress categories: child characteristics, parent-child interactions, family cohesion, parental adjustment, and adoptions service issues. Practice and research implications are discussed.     

The vicissitudes of adoption for parents and children

This paper attempts to illustrate how adoption is understood by children according to their developmental stages within the context of their families. Illustrations of children's thought processes and inner fantasies are presented in the form of interviews and observations. The inner thoughts and experiences of adoptive parents are also presented, from the time of the application process through infancy, toddlerhood, school age and adolescence. A major thesis is that adoptive parents who are comfortable with their own feelings about the birthparents and the child's specific history are more able to provide an atmosphere where the child feels valued when she asks questions or communicates fantasies about her story. In this manner adoption is integrated into the child's growing self-esteem and, as time goes on, the adoption becomes less important.The author wishes to thank Lynn Borenstein, L.C.S.W. for her helpful suggestions. Marilyn Silin, M.A. is on the faculty of The Institute for Clinical Social Work.