Children and young people with a hidden disability: an examination of the social work role

Summary There has been little research attention paid to the natureand extent of social work intervention with children and youngpeople with invisible impairments. The recent study describedhere found that children and young people with a hidden andstigmatizing impairment received a social work service whichwas at a minimal level. The children and young people were affectedby physically induced incontinence, and described how they facedan environment which created particular tensions. Their parentsconcurred with this overall picture and reported unmet needs.Recommendations are made about social services input, but itis recognized that the level of social services interventionavailable to these families may, in part, be a reflection ofa low priority assigned to disabled children generally. It isargued that, although such an assignment is a common picturein recent research about social services provision to disabledchildren, a change in priorities is needed which recognizesthe importance of coherent support to disabled children as ameans of improving their environment and thereby reducing families'stress levels and the likelihood of abuse or rejection.     

Sponsored Places: The Use of Independent Day-Care Services to Support Children in Need

Correspondence to: Dr June Statham, Project Director, Thomas Coram Research Unit, 27-28 Woburn Square, London WC1H OAA Summary The implementation of the Children Act 1989, with its emphasison family support through the provision of non-stigmatizinglocal services and on local authorities working in partnershipwith voluntary and private service providers, has given a newfocus to the use of independent day-care services to supportchildren in need and their families. This article uses datafrom research in England and Wales on the implementation ofthe Children Act as it affects early years services, to considerthe extent of sponsored day-care, the circumstances in whichit is used, and the issues it raises for local authorities,independent day-care providers and the children themselves.     

A Description and Analysis of Multi-Sectoral Fostering Practice in the United Kingdom

Correspondence to Clive Sellick, School of Social Work and Psychosocial Sciences, Elizabeth Fry Building, University of East Anglia, Norwich NR4 7TJ, UK. E-mail: c.sellick{at}uea.ac.uk Summary Foster care is the preferred placement option for children andyoung people in the public care system in Britain. In recentyears, fostering has been the subject of extensive policy andresearch review and its practice and services have been widelyexamined. Although still provided principally within the public,local authority sector, there has been a significant growthin the use of independent fostering agencies and a steady useof the fostering services of established voluntary child-careorganizations. This paper reports a recent review of innovativefostering practice in all sectors across the four countriesof the UK, which was commissioned by the Social Care Institutefor Excellence. All British fostering agencies were invitedto submit examples of what they considered to be innovativeor effective in respect of six main categories: foster carerrecruitment and training; retention and job satisfaction; placementprovision; fostering children with complex needs; service provision;and user evaluation. These were examined in the light of relevantresearch knowledge to determine the extent of ‘research-mindedness’amongst fostering agencies. The authors conclude with a critiqueof four key factors which are impacting upon contemporary fosteringpractice in Britain.     

Crossing Boundaries: An Exercise in Partnership Provision

Correspondence to Bill Whyte, Department of Social Work, University of Edinburgh, Adam Ferguson Building, George Square, Edinburgh EH8 9LL Summary The international movement to develop school enhancement strategiesin secondary schools recognizes the important relationship betweenschool, family, and community as a crucial medium for assistingdisadvantaged children (Crowson and Boyd, 1993). These childrenare equally the responsibility of social work and other publicservices. Many local authorities in Scotland throughout the1980s established what have become known as ‘youth strategies’to improve formal co-operation between education and socialwork, health and police services. This was an attempt to ensureearly identification of young people's difficulties in the expectationof promoting social welfare, enhancing educational attainment,and preventing, among other things, school absent-eeism andthe difficulties associated with school failure. In recent years,the ambition of such strategies has been to focus on primary-agedchildren and their families, as a preventive and protectiveapproach to the damaging effects of multiple disadvantage. Thispaper reports on an innovative project which was establishedto assist pre-school children experiencing multiple disadvantageto make a successful transition from home to primary school.The importance of good collaborative service provision is highlighted, together with an exploration of parents as educators,the provision of social services in an educational settiog.and issues of multi-disciplinary provision.     

Should any Child be Placed in Care? The Forgotten Great Debate 1841-74

Summary This paper first describes a system of Day Industrial FeedingSchools in the mid-nineteenth century known as the 'AberdeenSystem'. As originally conceived, it challenged the whole ideaof residential care of children. We argue that while SheriffWatson, with whom the schools are usually associated, is generallygiven a paragraph in histories of social work or of education,the social movement with which he was associated is entirelyoverlooked. This movement gave first importance to family ties,for religious reasons, and then argued on rational grounds theadvantages of a day care system. It attempted to meet withinsuch a system the needs of the whole child in his family andcommunity setting. It also sought to avoid the processes ofstigmatization, arguing that service provision should be basedon recognition of children's rights. We consider briefly theideological context of the movement and finally look very brieflyat some of the implications of the material for social serviceprovision today. We suggest that greater historical awarenesscould enhance opportunities for developing imaginative policiesin relation to the development of social work services     

Differential Assessment of Residential Group Care for Children and Young People

Summary Twelve qualitative variables frame the production of outcomesin residential group care for children and young people. Theseare used to examine contemporary themes in social care practicewith children and families. This assessment typology offerssocial workers, managers, researchers and policy-makers bothvalid and reliable baseline measures for use in evaluating residentialservices for children and young people. The typology also providescomparative interval measures for use in longitudinal evaluationsof quality. Close attention needs to be given to the impacteach of these variables has on the quality of residential groupcare services offered to children, young people and their familiesor significant others.     

An Innovative Project for Young People in Care Who have been Sexually Abused

Correspondence to Willm Mistral, The Mental Health Research and Development Unit, 3 East, 2.10, University of Bath, Bath BA2 7AY,UK. E-mail W.Mistral{at}bath.ac.uk Summary Professional awareness of child mental health problems and sexualabuse has increased greatly over the past 20 years, and thisis especially true for young people under the care of socialservices. The current paper provides an overview of the researchliterature on needs and service provision in this area. It goeson to describe an innovative interagency project in Dorset whichoffers flexible, fast track intervention packages to lookedafter young people with a profile indicating sexual abuse, whohave been reluctant to engage with conventional child and adolescentmental health services. The paper includes preliminary resultsfrom an evaluation of this project and discusses the implicationfor future service provision.     

Social Work and Child-centred Family Court Mediation

Correspondence to Dr Greg Mantle, APU, Ashby House, Floor 2, Brook Street, Chelmsford CM1 1UH, UK. E-mail G.J.Mantle{at}apu.ac.uk Summary In April 2001, the Children and Family Court Advisory SupportService (CAFCASS) became responsible for family court work,including the provision of mediation services. Family courtmediation offers a gateway for social work with children andfamilies whose needs are largely left untouched by current services,and could thereby play an important part within the broaderextension of prevention, early intervention, parenting and supportservices recommended by government. Over the past two decades,mediation has become a popular approach to reducing conflictand resolving disputes in a wide range of inter-personal, communityand organizational settings. Given the professional interestthat social workers have in helping their clients achieve moreharmonious lives, the space for mediation would appear considerableand yet the connections between mediation and social work are,as yet, insufficiently mapped and analysed, in terms of boththeory and practice. This paper draws on literature and recentresearch to review the relationship between family court mediationand social work.     

Children in Need? Listening to Children whose Parent or Carer is HIV Positive

Correspondence to Kay Tisdall, University of Edinburgh School of Social and Political Studies, Adam Ferguson Building, George Square, Edinburgh EH8 9LL, UK. E-mail: K.Tisdall{at}ed.ac.uk Summary International attention is being brought to the global HIV/AIDS epidemic. In contrast, HIV and AIDS risk being forgottenissues for those living in Scotland. Yet in 2002, numbers ofreported infections have begun to rise. Children and young peopleare even more likely to be affected by parental HIV now, asparents live longer and are able to have more children. Verylittle is known in Scotland about affected children and whethercurrent service provision meets their needs. This research projectsought to address certain of these gaps, by gathering quantitativedata from service providers and qualitative data from interviewing28 affected children and young people. The research found adearth in policies and services, and a failure to audit need.HIV education in schools did not acknowledge that pupils mightbe living with parents who had HIV illness. Children and youngpeople tended to be very involved in the health care of theirparent but none of them received direct support from healthworkers. On the whole the children and young people did notenjoy support from statutory social workers but appreciatedthe support and activities provided by workers in the voluntarysector.     

The Supervision of Child Protection Work

Correspondence to Alan Rushton, Course Director, M.Sc. in Mental Health Social Work, Social Work Department, The Maudsley Hospital, 101 Denmark Hill, London, SE5 8AZ, UK Summary It has frequently been recommended that statutory child protectionservices in Great Britain need greater provision of specialistsupervision to support front line social workers. This qualitativestudy, based in social services departments in London, usedthe focus group method to explore the provision of supervisionby team managers in a very pressurized work environment. Thestudy highlights the difficulty of protecting adequate supervisiontime but shows how supervisors can use their skills to conductcase related discussion concerned with developing professionalskills. ‘Inquisitorial’ and ‘empathic-containing’functions are identified and an approach is proposed for combiningthem in training courses for child protection supervisors. Thepaper recommends that supervision training needs to be expanded,to be more precisely targeted, and that outcomes need to berigorously and appropriately assessed.     

Cognitive-Behavioural Social Work with Children

Correspondence to: Dr Tammie Ronen, The Bob Shapell School of Social Work, Tel-Aviv University, Ramat-Aviv, Tel-Aviv 69978, Israel Summary The paper aims to explore the complex and important links betweeninterventions with children, cognitive therapy, and social work.Although children comprise about half of the referrals to socialwork services, they do not generally receive direct treatmentin these settings. Social workers are involved with childrenin the roles of mediator or counsellor and as the supervisorwho is concerned with the placement of the child in appropriatesettings. When the need for direct therapeutic interventionarises, children are usually referred to educational or clinicalpsychologists. Social work as a profession has been foundedupon a psychodynamic approach; however, social workers havealways been concerned with effective treatments, the definitionof clear goals, and the clarification of client needs. Thesefeatures link social work to cognitive-behavioural therapy.Cognitive therapy, although not frequently used with children,is presented in this paper as a means for conducting directinterventions with children which fulfil social work's basictargets and needs.     

The Social Work Role in Assisted Conception

¹ Eric Blyth, The University of Huddersfield, Huddersfield HD1 3DH, UK. Summary The provision of assisted conception has become a major industryin most industrialized countries, buttressed by powerful professionaland commercial interests. Assisted conception has significantimplications not only for those directly involved or affected,but also for wider society. The paper summarizes the contributionsocial work has made to the debate and to service development,especially in the UK. The author argues that the ethical valuesunderpinning social work, and the Knowledge and skills possessedby social workers, provide both an opportunity and a mandatefor social workers to influence the development of assistedconception services, in particular to ensure that the humanimplications of providing children for people who are involuntarilychildless are not subordinated to the pursuit of technical efficacy.     

Reconciling Cash and Care: Home Care Charges and Benefit Checks in Social Services

Correspondence to Pete Alcock, Health and Community Studies, Sheffield Hallam University, Collegiate Cresent, Sheffield S10 2BP Summary This article contains the report of a small research projecton the development of welfare rights checks for home care clientsin social services departments. Welfare rights take-up activityhas become an important feature of provision by local authoritysocial services departments, frequently targeted on particulargroups of clients known to experience problems in claiming fullbenefit entitlement. Users of home care services are such aclient group. Take-up work with home care clients is also, however,a product of the impact of community care policy changes andof financial pressures on local authority social services. Thesehave resulted in the introduction of charges for home care servicesby many authorities, and the use of rebates from such chargesto protect low income service users. Welfare rights work hasthus become an important feature of the reconciliation of thesenew charging policies with the continued service needs of poorhome care clients. The research examined a successful take-upinitiative, linked to home care charges, in Sheffield and contrastedthis with similar activities in other authorities throughoutthe UK. The conclusion is reached that levels of non-take-upof social security benefits are particularly low amongst homecare clients and that benefit checks can secure significantadditional income for them, which may also have the indirecteffect of increasing the income to social services departmentsfrom the charges for home care services.     

The Characteristics of Children with a Disability Looked After away from Home and their Future Service Needs

Correspondence to Professor Roy McConkey, School of Nursing, University of Ulster, Newtownabbey, N. Ireland BT37 0QB. E-mail: r.mcconkey{at}ulster.ac.uk Summary Little is known about the characteristics of children with disabilitieswho meet the British legal definition of ‘looked after’children. Data were obtained on 108 such children living withinone geographical area in Northern Ireland and who spent 90 daysor more in a 12-month period living away from the family home.However, this figure may under-estimate the numbers, given thedifficulties in tracking children aged over 14 years who wereadmitted to hospitals on a short- or long-term basis. The medianage of the children was 14 years; most had learning disabilitiesallied with challenging behaviours, communication difficulties,autism and some were technologically dependent. Many of theirfamilies experienced a range of problems. One-third of the childrenwere accommodated in various residential settings but half ofthese placements were in hospital or adult residential accommodation.However, there were marked differences in the services providedto this client group by the four provider agencies. Future serviceneeds included increased respite breaks for families and theprovision of both more residential placements and more appropriateaccommodation, especially for teenagers. The dilemmas in reconcilingthe need for local, but specialized, service provision are discussed.     

A New Approach to Community Care for the Elderly

Summary Organisations can absorb successfully only a few fundamentalinnovations within a short period of time. It is therefore importantfor the designers of innovations to ensure that they directlyand substantially contribute to solving important problems,and for agencies to concentrate their innovative activity onthose that do so contribute. The first aim of this paper isto analyse the policy context so as to clarify the nature ofthe problems that make innovation in the care of the elderlyimperative and show how features of the Community Care Projectcontribute to their solution. The second aim is to provide somepreliminary evidence of the success of the scheme. The analysisof data for seventy persons in the experimental and controlgroups shows that the experimental group fared better in a numberof important ways; and that the gains appear to have been madeat no extra cost to the social services department. Therefore,it is concluded, the adoption of the scheme may contribute tothe technical progress needed in the provision of social serviceto the elderly with needs at or above the margin for residentialcare.     

Public Attitudes to Problem Definition and Problem Solving: A Pilot Study

Summary An attempt is made to discover how people define their problemsand on what basis they decide when, and from where, to seekhelp. The focus is upon legal problems since the study formspart of a wider project concerned with the provision of legalservices. Ignorance and misinformation concerning the availabilityof both social and legal services, combined with apathy andresignation on the part of many who need help, are importantfactors determining the non-use of services. Nor can people'sneeds be neatly categorized as social or legal. The overlappingnature of their problems exists at a structural as well as anindividual level; many of the legal problems experienced byindividuals arise from inequalities in the social and economicstructure of society.     

Adopted Children in Care

Correspondence to David Howe, School of Economic and Social Studies, University of East Anglia, Norwich NR4 7TJ. Summary Four local authority social services departments were surveyedto determine the number of adopted children who were currentlyin their care. The biographical characteristics of these childrenand the reasons for them entering care are reported. The adoptivedimension is discussed as a possibly relevant factor in theassessment and treatment of these children and their families.It is concluded that appropriate practice in this field requiresspecialist skills and understanding.     

Implementing the Children Act: The Regulation of Day-care Services for Young Children

Correspondence to Julie Bull, Research Officer, Thomas Coram Research Unit, University of London, Institute of Education, 27/28 Woburn Square, London WC1H 0AA Summary This article presents the findings of the first stage of a studyundertaken by the Thomas Coram Research Unit at the Universityof London for the Department of Health. The study aims to monitorand evaluate the implementation of Parts III and X of the ChildrenAct, which relate to the provision of dhy-care and pre-schooleducation for children under eight. The article reports thefindings of the first stage of the study on the aspects of implementationinvolved in the regulation of children's services, which isone of the most significant of the changes heralded by the Actfor under-eights' services. Based on the findings of a studyin eighteen English authorities and eight Welsh counties, thearticle outlines the different approaches taken to regulationin terms of organizational structures, degree of consultationwith providers, and overall approach to implementing the newsystem. The response of providers as reported by local authoritystaff is also discussed. The findings of the study are set inthe context of the current policy debate about the role of regulationand the status of the recommendations in the Guidance accompanyingthe Act. As well as outlining the degree of vanation found amongauthorities and indicating some of the ‘pressure points’in implementation, the article raises issues of critical concernabout the role of regulation in the context of the private marketof day-care provision.     

The Quality Dimension. Evaluating Quality of Service and Quality of Life in Human Services

Correspondence to Stephen P. Osborne, Public Sector Management Research Centre, Aston Business School, Aston University, Aston Triangle, Birmingham B4 7ET. Summary This paper addresses the issues, for those involved in planningand managing human services, of evaluating the quality of suchservices as part of the service provision process. It beginsby examining the nature of quality itself and moves on to lookat the links between quality of life and quality of servicein human services. It then assesses existing models of evaluationwhich might be applied and highlights their strengths and limitations. The paper argues that many of the models have their roots inareas outside of direct service provision and consequently arenot appropriate for implementation in this context. It concludesby reviewing some principles to guide the evaluation of servicequality by service managers, and suggests how these might beapplied in practice to the evaluation of the quality of humanservices.     

Residential and Foster Care in the European Community: Current Trends in Policy and Practice

Correspondence to Dr Matthew Colton, Department of Social Policy and Applied Social Studies, University College, Swansea SA2 8PP. Summary This article compares residential care, foster care and theiralternatives in the countries of the European Community. Thefollowing common trends in policy and practice are examined:the decline of residential child care; changes in the populationof separated children; the trend towards small-scale provision;the development of an ecological perspective; increasing differentiationof care provision; professionalization; and alternatives toresidential and foster care. The pace of development is uneven across EC countries. Overall,the trends high-lighted are more apparent in the northern countriesthan in the southern states.