Family centres: a focus for the children in need debate

The development of child care policy has been characterized by debates organized along various intersecting constructs such as universal vs. selective services and prevention vs. treatment. Family centres, as a site of service delivery, represent a point of intersection of many of these arguments. Their role is contested between protagonists of all positions within the child care policy debates: whether they should be professionally managed, led by service users, provide a service to referred families, or offer a universal resource for local communities. This paper argues that a needs-led approach to family centre development may supersede the sterile dichotomies of many of these debates. A case study is presented of an evaluation research project, designed to inform a needs-led family centre policy for an urban unitary social services department. The methodology utilizes an approach combining quantitative analyses of geographical distributions of family need with qualitative presentation of the perspectives of actual and potential centre users, and agency stakeholders. The outcome is a family centre model which, by focusing on need, seeks to transcend the limited oppositions of the child care debates.     

Resettlement challenges faced by refugee claimant families in Montreal: lack of access to child care

Adult refugee claimants experience several well‐documented post‐migratory challenges. Little is known about the resettlement process for refugee claimant families with children. This study reports on 75 open‐ended, in‐depth interviews with refugee claimant families in Montreal about their resettlement challenges and their proposed solutions to them. These interviews were conducted with 33 dyads and triads of children and parents attending a paediatric hospital. Experiences accessing formal and informal child care in Montreal were addressed. Subsequently, a comparative policy analysis was conducted on residency eligibility criteria for child care subsidization. Twenty‐eight out of 39 parents (73%) report a lack of informal or formal child care and 15 out of 33 families (39%) propose improving access to formal child care services. They describe a lack of informal child care as a result of reduced social networks, and affordability as a barrier to formal child care services. Refugee claimants are not eligible for subsidized child care in Quebec. A comparative policy analysis within Canada and comparable countries reveals that this situation is not unique to Quebec. However, most provinces and European countries offer child care subsidies to refugee claimants. Refugee claimants should qualify for child care subsidies. Social workers and community organizations should consider their clients' child care needs in designing programmes and services.     

Contested Housing Landscapes? Social Inclusion,Deinstitutionalisation and Housing Policy in Australia

Deinstitutionalisation is represented as a major step toward social inclusion through the resettlement of disabled people residing in segregated large‐scale institutions into community‐based homes. By promoting the right to live in ordinary community residential settings, deinstitutionalisation fundamentally changes both the support services and housing arrangements of former institutional residents. In Australia, as in many western countries, debates on community care have tended to focus on the location and nature of non‐housing supports for people leaving dependent care. This focus, however, overlooks the fact that deinstitutionalisation involves a radical rehousing of people in care. This paper explores the character and implications of deinstitutionalisation in Australia as a rehousing process. It is based on a recent national research project that has examined the housing futures of people with intellectual disabilities who have been, or will be, deinstitutionalised. The paper considers the increasingly divergent socio‐political perspectives that have emerged in recent discussions about social inclusion, institutional reform and independent living and their implications for housing and community care policies.     

Implementing Care Management: Issues in Relation to the New Community Care

Correspondence to Professor Jane Lewis, All Souls College, Oxford OX1 4AL Summary The official guidance on the new policy of community care emphasizedcare management as the means of securing needs-led services,together with user empowerment and choice. This paper uses datafrom eighteen months intensive fieldwork in five local authorities,first, to examine the very different interpretations of caremanagement in these authorities; secondly, to examine two majorsources of difficulty in the implementation of care managementsystems—the simultaneous development of purchaser/providersplits, and the tension between needs and resources—and,finally, to draw some conclusions about the implications ofcare management for social workers.     

GPs and Contracts: Bringing General Practice into Primary Care

This paper argues that the terms on which GPs entered the NHS, as self-employed contractors, have proved remarkably resistant to the managerial pressures which have come to dominate other sections of the National Health Service. However, this traditional mode of financing and organizing the delivery of a key element of the National Health Service has become increasingly incompatible with wider health policy objectives—the development of an integrated network of good-quality, equitable and well-coordinated primary and community health services which are responsive to local needs. Furthermore, primary health services have themselves come to play a crucially important role in securing other strategic changes in the wider health policy arena, such as securing and sustaining a shift in the traditional balance between hospital and community-based health services and controlling expenditure in a needs-led service. The paper argues that, notwithstanding the change of government, the 1997 NHS (Primary Care) Act and the White Paper "The New NHS" are both integral to the achievement of wider strategic health policy objectives, such as improving the quality and coherence of services, and increasing professional accountability for the financial consequences of clinical decisions. However, the greatest significance of these and other related measures is that they shift the emphasis of health policy from commissioning and purchasing by primary care to commissioning and contracting for primary care. They thereby extend the exposure of GP-based services to managerialist scrutiny and control.     

灾后安置社区“弄堂会”模式下优势视角的社工介入——以都江堰市居民安置社区“勤俭人家”为例

“5·12”汶川地震灾区安置工作全面展开。根据西方发达国家以及我国台湾等地区的经验,社会工作作为以服务困难群体为天职的专业,在长期的灾后重建中会发挥不可替代的重要作用。因此,本研究试图运用社会工作的优势视角,以都江堰勤俭人家安置社区自我管理“弄堂会”的开展为例,来分析上海社工首批队员对震后安置社区的介入过程,期望为今后安置社区的社工介入提供一定的参考与借鉴。     

The impact of resettlement on Karen refugee family relationships: A qualitative exploration

Refugee resettlement policy in the United States prioritizes family reunification, meaning, resettling families that may have been separated for years are reuniting and reestablishing connections while integrating into a new culture. Scholarship on the impact of resettlement and integration has focused primarily on the individual level, despite evidence that strong family relationships are a documented protective factor for refugee families. This paper aims to explore the impact of resettlement on Karen refugee families' relationships. Data from 6 focus groups with 36 Karen refugee community members and interviews with 8 key stakeholders suggests that refugee families are at risk of a constellation of relational issues that are exacerbated by the stress of resettlement. Data also indicates that families have indigenous strategies for solving problems that could be harnessed to develop culturally relevant family support services.     

Multiple Family Group Therapy for Families with Children Placed in Out-Of-Home Care in a Chinese Context

Since the 1980s, the family-centered approach has been widely adopted in the west (e.g., the United States) as an approach to serving children living in an out-of-home care context. In comparison, in Hong Kong, out-of-home care services tend to be child-centered and child-protection oriented. This article (1) examines the child welfare service, specifically out-of-home care services, in Hong Kong and (2) makes the case for integrating family-centered out-of-home care services for children. Three vignettes are presented that demonstrate the use of Multiple Family Group Therapy (MFGT) to promote family-centered practice. The article concludes with a discussion of challenges and recommendations related to a shift to family-centered practice.     

Child Welfare in England: Problems, Promises and Prospects

This paper discusses developments in child welfare services in England in recent years and, particularly, the role and contribution of research. It is shown that a more significant and coherent body of child welfare research has been developed, which has linked formally to the policy process. Research programmes in England have highlighted specific problems in three areas: first, moving away from a narrow focus on child protection to an approach that provides broader family support for children in need; second, the absence of policies relating to services for adolescents; and, lastly, problems in the delivery of residential care for young people. A major programme of reform has been introduced by the new Labour government, consistent with research messages. It is concluded that research has had an impact on the development of child welfare services in England, although influencing the structure of services, social work practice and outcomes for young people are highly complex issues.     

Measuring children's needs: how are we doing?

Children's services in England and Wales are legally required to determine the nature and extent of children's needs in their areas as a precursor to providing needs-led services. However, few needs assessments are ever published. This article analyses 83 such reports conducted between 1999 and 2007 in two local authorities in England (one urban, one rural), focusing on their quality and usefulness. It makes recommendations for improving practice in this important area, both in terms of the type of needs assessment required and how best to produce and use them.     

“It's not all tied up with bureaucrats and funding”: Autonomous volunteer participation in the rural resettlement of refugees

This paper reports on a study that explored the experiences, perceptions and motivations of a new type of autonomous volunteer emerging in modern society, in particular, those working to assist in the rural resettlement of refugees in Australia. The volunteers filled a gap left by under resourced government and community services. In‐depth semi structured interviews revealed that their motivation was due in part, to the lack of bureaucratic' red tape'. Their drive to address social issues was based also in part on values to see social justice expressed in their community. Some challenges and tensions due to cultural differences were identified. Questions for community development and social capital are raised. Implications are raised for volunteer groups' and resettlement organisations' policy and practice to enhance the resettlement process for both the host community and those with a refugee background.     

The Interdisciplinary Geriatric/Gerontological Team in the Academic Setting

Geriatric health care requires the services of an interdisciplinary health care team to assess, treat and order the social service needs of the older person, and this concept needs to be included in geriatric social work education. But while the necessity of interdisciplinary team care is recognized, little focus has been placed on the actual process of developing a functional team. The issues that arise-disparate terminologies, organizational and administrative differentials, turf-and the steps needed for a team to become viable are described, using an interdisciplinary team based in academia as a case model. The academic interdisciplinary team may easily become a forum for 'hot air' rather than a catalyst for good practice. This danger is reviewed with reference to stages in the interdisciplinary team development-- goal development group affiliation; team awareness; and goal evaluation. The chapter concludes with a discussion on the impact of the interdisciplinary team on faculty, students and the academic setting.     

Bridge Builders: A Qualitative Study Exploring the Experiences of Former Refugees Working as Caseworkers in the United States

ABSTRACT.

Individuals who come to the United States as refugees and work as resettlement caseworkers offer peer support, modeling, and assistance with integration to newly arriving refugees, despite often having limited training or experience in social service provision. A phenomenological approach was utilized to gain understanding about the experiences of refugee caseworkers. Nine caseworkers who came to the United States as refugees completed in-depth interviews. Thematic analysis was used to identify primary themes, including: a) the caseworker's bridge-building role with clients; b) their role in building bridges with others in the community, including the resettlement agency; and c) the caseworkers’ experience as bridge builders, including motivations, perspectives toward their role, and needed supports. Refugee service providers face unique challenges in negotiating boundaries with clients and meeting the expectations of their ethnolinguistic community members. Their strengths in understanding household experiences and in building agency and community understanding highlight their ability to contribute to positive resettlement outcomes. The findings from this study have implications for agencies serving refugees and for other social services that utilize peer-support strategies, particularly in regards to staff training and support. Findings highlight the need for research examining effective resettlement strategies and the perspectives of refugees toward resettlement approaches.     

Developing congruent children's services to improve child well-being

This paper explores whether different concepts of child well-being call for different 'service styles' and, if so, whether these styles can dovetail together to form a congruent pattern of children's services. The first part draws on the distinguishing features of five approaches to conceptualizing well-being – need, rights, poverty, quality of life and social exclusion – and their empirical manifestations ('conditions') to identify different emphases or 'styles' in service provision. The second, more discursive part of the paper explores potential contradictions between these service styles, for example, between needs-led and rights-based approaches or between policies to tackle poverty and combat social exclusion. The third part examines whether and how such contradictions can be minimized to achieve greater congruence and discusses the need to consider the orientation of children's services in respect of interpretations of child well-being.     

The proof of the pudding: What difference does multi‐agency working make to families with disabled children with complex health care needs?

More than 20 years of research with disabled children, young people and their families has highlighted the need for the different professionals and services that support them to work more closely together. The British policy and legal framework for ‘joined up working’ has never been stronger. However, there has been an assumption that multi‐ or inter‐agency working will inevitably be a ‘good thing’ for families. This paper discusses findings from a 3‐year research project which looked at both the process and impact of multi‐agency working on families with a disabled child with complex health care needs. Interviews with 25 parents and 18 children and young people who used six developed, multi‐agency services were carried out. Findings suggested that the services had made a big difference to the health care needs of disabled children but were less able to meet the wider needs of the child and the family – particularly in relation to social and emotional needs. Multi‐agency working appeared to make some positive, but not significant, differences to the lives of families.     

Refugee family reunification and mental health in resettlement

Family reunification is widely recognised as a vital issue for people from refugee backgrounds, but relatively little research has been reported on its relation to mental health or resettlement outcomes. A study was carried out over the course of 2011 involving 46 participants from refugee backgrounds with direct experience of the family reunification process in New Zealand. Participants from multiple ethnic communities in Auckland, Wellington and Hamilton were invited to discuss and share their experiences. Structured individual interviews were carried out with 15 individual participants, as well as 13 focus groups, in addition to detailed reviews of case histories. Research questions focused on the perceived impacts of family reunification on resettlement outcomes, health and wellbeing. Eighty-five percent of participants reported family reunification issues as the paramount obstacle to their successful resettlement. Potential practical applications, limitations and priorities for future studies are discussed.     

Current Developments in Social Care Services for Older Adults in the Czech Republic: Trends Towards Deinstitutionalization and Marketization

ABSTRACT

Deinstitutionalization and marketization of eldercare has been delayed by 20 years in the Czech Republic compared to Western Europe, and it takes place in a completely different context, characterized by the legacy of communism, a growing older population, and less generous public subsidies. This study is the first in the Czech Republic to examine how deinstitutionalization and marketization effect implementation of these principles on the availability and quality of eldercare services at regional and municipal levels. A mixed-method approach was used, combining several data sources (policy documents, administrative data, statistics, expert panel, and secondary use of qualitative data). The findings suggest that the support for and availability of home-based care has declined, despite the ever-increasing number of older adults and policy preference for deinstitutionalization. Furthermore, home-based services have failed to adjust to growing care needs of older adults (e.g., inflexible schedules, limited provision of time-demanding care, inadequate staff composition). This situation occasioned an unintended outcome: the emergence of nonregistered, semilegal, for-profit nursing homes offering low-quality care and poor working conditions, and subject to no quality control. The health and even lives of older adults are at risk if they choose such services. Research is needed to study older adult decision making and offer them tools to identify and avoid questionable services.     

Human Motivation and Professional Practice: of Knights, Knaves and Social Workers

Efforts to improve the efficiency and responsiveness of public services by harnessing the self‐interest of professionals in state agencies have been widely debated in the recent literature on welfare state reform. In the context of social services, one way in which British policy‐makers have sought to effect such changes has been through the “new community care” of the 1990 NHS and Community Care Act. Key to this is the concept of care management, in which the identification of needs and the provision of services are separated, purportedly with a view to improving advocacy, choice and quality for service users. This paper uses data from a wide‐ranging qualitative study of access to social care for older people to examine the success of the policy in these terms, with specific reference to its attempts to harness the rational self‐interest of professionals. While care management removes one potential conflict of interests by separating commissioning and provision, the responsibility of social care professionals to comply with organizational priorities conflicts with their role of advocacy for their clients, a tension rendered all the more problematic by the perceived inadequacy of funding. Moreover, the bureaucracy of the care management process itself further negates the approach's supposedly client‐centred ethos.     

The comfort of strangers: social work practice with unaccompanied asylum-seeking children and young people in the UK

Unaccompanied children and young people seeking sanctuary as political refugees are increasingly visible within many industrialized nations, where several studies confirm their vulnerability and needs. These studies also highlight what appears to be the poor quality of social work services and practices that these minors encounter. This paper examines some of the details contained in such reports of deficiency and seeks to place them within a more optimistic appraisal of social work practice. Based on a small research study, it suggests that resettlement for unaccompanied minors is complex and contains different types of loss as well as gain. It also asserts that practice by some social workers shows they have a grasp of this complexity as they offer practical assistance, therapeutic care and companionship to the young people to help them resettle in new environments.     

THE LABOUR MARKET EXPERIENCE OF CAMBODIANS: POLICY IMPLICATIONS FOR SETTLEMENT SERVICES

A proportion of the annual migrant intake now comprises persons accepted under the Refugee and Special Humanitarian Program entry categories, for reasons other than the direct contribution their skills can make to economic growth. This paper examines the labour market experience of Cambodians, and considers the policy implications for resettlement services for refugees. Cambodians experience high rates of unemployment, and have low levels of English language proficiency, low levels of educational attainment, and few possess post-school qualifications. Reluctance to develop settlement services for refugees, to make special provisions for access within existing services, or even to ensure equitable access to existing services has contributed to the long term economic dependency of a sizeable proportion of this group. It is recommended that they be given greater access to basic, advanced and job related English language tuition. They, and other refugees with similar disadvantages also require special access to job search skills programs, vocational training, and wage subsidy and special employment programs.