The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

Improving mental health assessments in child protection through audit

Existing agency records, together with questionnaires completed by social services referrers and mental health providers, were used to identify problems in current arrangements for obtaining specialist mental health assessments in child protection cases. Standards were set and implemented through a multi‐agency steering group. The practice of referrers and providers was then reaudited. Sixty‐nine social workers, six mental health specialists and 27 child protection initial case conferences (involving 31 children) were involved in the reaudit over a 4‐month period. Initially, main problems concerned communications, unclear referral and access arrangements, waiting times and disagreements over prioritization. Standards concerned consultation and decision‐making arrangements within the child mental health service, the format of referral and reply letters, the sharing of information and the attendance of mental health professionals at child protection case conferences. There appeared to be improvements in all these areas at reaudit. In conclusion, some shared views of problems, additional support funding and the audit process appear to have helped to improve inter‐agency collaboration and develop more efficient referral and care arrangements. There is a need to maintain and further develop this work, and audit would again be a useful means. Copyright © 1999 John Wiley & Sons, Ltd.     

The experiences of children living with and caring for parents with mental illness

This research provides a three‐way perspective on the experiences and needs of children who are living with and caring for parents with severe and enduring mental illness. The views of children, parents and key workers were sought in order to provide deeper insight into the needs of families and the nature of interfamilial relationships, as well as the relationships between service users and providers. Child protection and medical research has long proposed a link between parental mental illness and the risk to children of abuse, neglect and developmental delay. The inevitability of risk associations is challenged by the research described here and outcomes for children of caring for parents with mental illness are discussed not simply in terms of risk to children but more broadly in respect of, for example, positive parent–child relationships. Copyright © 2006 John Wiley & Sons, Ltd.     

Child abuse and neglect in Cambodian refugee families: characteristics and implications for practice

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts.     

The use of multidisciplinary teams to support child welfare clients

Meeting the educational needs of young people in the child welfare system (CWS) requires effective collaboration between the CWS and the education system. In Norway and in other countries, there is an increased focus on interprofessional collaboration to support child welfare clients in and around schools. Multidisciplinary teams are employed to facilitate collaboration and coordinate supportive measures. The purpose of this article is to describe how teachers and social workers use such teams as part of a collaborative effort to support children living in difficult conditions. In an inductive thematic analysis of 13 interviews with 7 social workers and 6 teachers, the following five key themes were revealed: (i) solution-focused work; (ii) listening to the child; (iii) parental support; (iv) social/environmental opportunities for successful interactions and (v) ensuring school attendance through adapted education and support. In conclusion, we discuss the ways in which these themes reflect how teams support child welfare clients.     

Financial oppression and post-separation child positions in Sweden

The present paper deals with post-separation child positions in two domains of practice in the Swedish welfare state: welfare benefits such as financial aid and child contact. The area of concern is financial oppression in the context of parental separation. Empirically, the study draws upon three types of material: interviews with victimised mothers, court orders in welfare benefit appeals and court orders in contested contact cases. Findings suggest that financial abuse in the context of parental separation is a non-question in the domain of welfare benefits, and in the domain of child contact framed as a conflict between equal parties. Object without voice and with needs ignored was the typical child position in welfare benefits cases, whereas incompetent subject was more prominent in child contact cases. Age order as a form of domination may be reinforced by the practice of both domains.     

Participatory discourse: Engagement in the context of child protection assessment practices from the perspectives of child protection workers,parents and children

ObjectiveThis article describes empirical results of the views of child protection workers, parents and children along different dimensions including interpretation of engagement, approaches with families in the engagement process, collaboration and relationship, barriers and factors promoting engagement.MethodA qualitative study was undertaken of a sample of eleven child protection workers, eleven parents and eleven children in one county in South-Estonia. The study explored the participants' experiences and perspectives of the engagement, within the context of assessment in child protection practice, through in-depth semi-structured interviews.ResultsResults indicate that child protection workers demonstrate an over-reliance on expert- and deficit-based approaches, indicating a requirement for a focus on traditional social work assessment, concentrating on problems, and more investigative, coercive, and judgement-focused approaches. Both workers and parents valued the quality of relationships, emphasising trust, dialogue and support as important elements of engagement. According to children, they were not always considered as a subject in the assessment process, including their needs as the primary focus; children expressed the wish to be more heard and understood, with their opinions being taken into account.ConclusionsFindings propose that child protection workers are ‘stuck in the past’, in traditional deficit-based discourse, however families prefer ‘modern’, strengths-based perspectives.     

Facilitating Mental Health Service Use for Caregivers: Referral Strategies among Child Welfare Caseworkers

Unmet needs for mental health care are common among caregivers involved in the child welfare system. Although child welfare caseworkers are well positioned to identify service needs and refer caregivers to treatment, little is known about the types of referral strategies used in practice, or their effectiveness for promoting mental health service use. The current study examined child welfare caseworkers' use of different referral strategies and the extent to which these strategies are associated with caregivers' receipt of mental health services within a national sample of child welfare cases. Analyses of the second cohort of families from the National Survey of Child and Adolescent Well-Being suggest that child welfare workers more often use informational strategies for referring caregivers, including suggesting treatment or providing information about treatment options. However, social referral strategies such as providing caregivers with direct assistance in completing applications and making and attending appointments were associated with a greater likelihood of caregivers receiving mental health services. Findings support evidence from other service contexts that service use is facilitated by caseworkers' direct support for arranging services. Implications for research and for child welfare managers and administrators are discussed.     

Caseworkers' perspective on risk factors in the family environment influencing mothers' difficulties in meeting children's needs

ObjectivesThis study examines, from the caseworkers' point of view, which needs of children are the most difficult for parents in neglectful contexts to respond to and which risk factors make this response more difficult.MethodA sample of 55 parents being followed by child protection services for neglect or high risk of neglect accepted to participate in the study. Their caseworker filled out a grid regarding the response provided to the children's needs and the risk factors in the family environment.ResultsThe results indicate that the children's age is related to the difficulties of responding to their needs. The caseworkers are particularly concerned about guidance and boundaries provided to preschool-age children, but less so about that provided to school-age children. When the children's age is controlled for, parents' mental health problems explains a significant proportion of the variance in parents' response to their children's need for stimulation, emotional warmth, and guidance and boundaries. Caseworkers' worries about drug and alcohol misuse also explain a significant proportion of their concerns about the mothers' ability to ensure their child's safety.ConclusionCaseworkers are more worried about the parental response offered to preschool children than to school-age ones. However, a constant and coherent response to growing children is still important for their developmental trajectories. Moreover, mental health and substance abuse explain caseworkers' concerns about mothers' engagement toward their child. These data raise questions about which type of services to offer, because intervening in families where parents deal with personal issues while addressing child neglect is complex.     

Wraparound Services: An Effective Intervention for Families Impacted by Severe Mental Illness

ABSTRACT

Children and families impacted by severe mental illness (SMI) have multiple strains that effect family functioning, child safety, and parental rights. Traditional services for children and families struggling with severe mental illness have not achieved success in improving family functioning and keeping families intact. Wraparound is a philosophy and a system of care with a promising evidence base that could enhance collaboration of child welfare, mental health, and community services to work more effectively with families impacted by SMI.     

What would you learn to improve your work in child protection? Social workers’ continuing education requests

This article presents the results of a study of the continuing education requests of child protection social workers. The work presented is part of a larger research project realized in Lombardy (a region of Italy), conducted to gain knowledge and data about social workers’ opinions, activities, and workloads. Through the participation of 300 child protection social workers engaged in fieldwork, a specific part of the research was dedicated to continuing education requests. Starting with their perceptions about the competences and abilities required for practice, social workers were invited to express their opinions about educational needs. Using an online survey constructed ad hoc, the social workers’ continuing education needs were investigated first with multiple choice questions and subsequently using a priority scale. The interviewees expressed educational needs in 22 different areas. The data collected open perspectives to new child protection work and encourage the people responsible for education to support democratic and participatory approaches. The conclusions offer suggestions for social work education and practice.     

Worker skill and client outcome in child protection

The research in child protection and in work with other involuntary clients suggests that the use of certain skills by child protection workers is likely to be related to positive client outcomes. In particular, effective practice involves: helping clients and client families to understand the role of the child protection worker; working through a problem‐solving process which focuses on the client's rather than the worker's definitions of problems; reinforcing the client's pro‐social expression and actions; making appropriate use of confrontation; and using these skills within a collaborative client/worker relationship. This study attempts to identify the extent to which child protection workers make use of these skills and how these skills relate to client outcomes. Data were sought through 50 interviews with child protection workers and 282 interviews with family members. The child protection workers provided information about 247 client families. It was clear that when workers used the skills, their clients had better outcomes—the workers believed their clients showed better progress, the clients were more satisfied with the outcomes and the cases were more likely to have been closed 16 months later. Copyright © 2002 John Wiley & Sons, Ltd.     

Job-strain and well-being among Finnish social workers: exploring the differences in occupational well-being between child protection social workers and social workers without duties in child protection

Work-related mental distress and its impact on employees’ working life is a mounting issue among Finnish social workers. This article focuses on identifying the factors associated with child welfare social workers’ occupational well-being. The occupational well-being of Finnish child welfare social workers (N?=?364) and social workers whose duties do not include child protection work (N?=?524) was explored and compared with each other using t-test statistics and logistic regression analysis. The data, collected in 2014/2015, were obtained from an ongoing longitudinal cohort study on work-related well-being among Finnish public sector employees. A multi-dimensional and holistic approach to occupational well-being was used as the outline for the analysis and comparison of the two groups. Child protection social workers reported higher levels of burnout and secondary traumatic stress than social workers without child protection duties. Despite these burdens, both groups showed a similar level of general health, compassion satisfaction and overall occupational well-being. Individual and organizational factors associated with high occupational well-being were identified. Supervision was found to be an important supporting element. This study identified multiple determinants related to social workers’ occupational well-being, comprising positive and negative elements with regard to organizational and individual factors.     

The Psychological Best Interests of the Child

The "best interest of the child" is the central principle in legal disputes concerning the placement of children. Since the concept is invoked in both law and mental health, it is often viewed as meaning the same to both professions. This idea is false. Psychologically, the determination of best interest depends on the emotional life of the child, especially present and future intimate relationships. Legally, best interests include moral, financial, and multiple other factors in addition to psychological aspects. Moreover, mental health professionals tactly consider best interests as the ultimate principle in placement whereas the law considers other principles to be prior to best interest (e.g., equal protection of parents or society's needs). Opinion of mental health workers is limited to psychological considerations, which are not decisive in determining the legal best interests of the child.     

Using child abuse inquiries in child protection education and training

In this article the two authors describe and analyse their experiences of using child abuse inquiries in child protection education with pre-qualifying social work students, over a period of 10 years. The article addresses a range of issues, including the effects of changes in child protection policy and practice; changes in social work education; the cumulative effects of the number of inquiry reports over the past 25 years; use of particular inquiry reports to discuss issues of oppression; the importance of sensitivity to the processes of such teaching and the emotional impact on social work students. The authors, one woman and one man, are both white and in their middle years. Prior to teaching social work, both were in child care and child protection practice for many years. One author's experience of sexist oppression informs particular aspects of the content of this teaching (see article) and both authors' experiences of endeavouring to be aware of, and sensitive to, the needs of social work students as individuals and as groups, has led them to take a particular approach when using child abuse inquiry reports in educating social workers in the complex and contested field of child protection practice.     

Evaluating the Effectiveness of the Reframing Technique in Psychodynamic Social Work Practice

This multiple case study responds to the need for process and effectiveness studies in mental health social work practice through providing an in-depth analysis of the operationalisation of the reframing technique from a psychodynamic perspective. The practitioner–researcher studies (1) the way reframing (theory) is applied in the work with the parents of six latency aged children suffering from child separation anxiety disorder (practice) and (2) the effects of the technique on the parents and their relationship with the child. Reframing provided relational meaning and accordingly modified the parental ambivalence to bring the child for assessment, the parental inability to set boundaries on child aggressive behaviours, the parental child overprotection behaviours, the separation anxiety symptoms of the child, the parental phobic anxiety, the emotionally painful parental psychosocial histories, and the parental couple relationship problems. The study establishes that the concept of reframing is worth further exploration in mental health social work practice.     

The elementary-school functioning of children with maltreatment histories and mild cognitive or behavioral disabilities: A mixed methods inquiry

This mixed methods inquiry examined the school functioning of elementary school-aged children with maltreatment histories and mild cognitive or behavioral disabilities. Quantitative analyses of linked social service and education administrative data bases of 10,394 children in Minnesota with maltreatment histories indicated that 32% were eligible for special education services. Of those children with maltreatment histories and identified disabilities, 73% had mild cognitive or behavioral disabilities. The most frequent primary disabilities categories were specific learning disabilities (33%) and emotional/behavioral disabilities (27%). Children with maltreatment histories and mild cognitive or behavioral disabilities scored significantly below children with maltreatment histories and no identified disabilities on standardized assessments of math and reading, and this gap increased with grade level for math. Qualitative interviews with 22 child welfare professionals and 15 educators suggested why some children with maltreatment histories, especially those with mild cognitive or behavioral disabilities, struggle in school. Risks to school functioning included children's and families' multiple unmet basic and mental health needs which can mask or overshadow children's mild disabilities; poor cross systems collaboration between child welfare, education and mental health systems; and inadequate funding, especially for mental health services. Protective factors included child engagement in school, parent engagement with child welfare services and a professional culture of cross-systems collaboration. Implications are discussed for holistic child, family and system-level interventions.     

Parental substance misuse and child protection in a British sample. A survey of children on the child protection register in an inner London district office

The relationship between parental misuse of alcohol and/or illegal drugs and child maltreatment has received considerable attention in the USA, while comparatively few British studies have been published. In both countries, research suggests that it is a large and growing problem and that it has a significant negative impact on children. This study looks at 50 families with 95 children on the Child Protection Register (CPR) in an inner London area through an examination of files and social workers' rating of parental substance misuse as a child protection concern. Parental substance use, as defined by social workers, was considered by social workers to be a cause for concern in 52% of families. Alcohol (in 24% of families) and heroin (in 16%) were the main substances of concern. Substance misuse was strongly related to neglect and cases were twice as likely to be subject to care proceedings. Very little involvement of substance misuse professionals in child protection procedures was found. Different profiles of social work concern were found for alcohol and for illegal drugs. Reasons for this difference and areas for further research are discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Parental substance misuse and child care social work: research in a city social work department in England

This research set out to establish evidence about the scale and impact of and response to parental substance misuse in child care social work teams in a city social services department in England. The article draws on some aspects of the data collected in the research, which includes: a snapshot survey of all child care social work caseloads in the city; group interviews with practitioners and parents in recovery; individual interviews with parents using a pilot project that focused on parental substance misuse. The research provides evidence of parental substance misuse as a key factor that needs greater consideration within child care social work assessments and as an issue to target in developing preventative responses to child welfare concerns. Child care social workers are shown to need specialist support in undertaking this task to best effect. Copyright © 2004 John Wiley & Sons, Ltd.     

What mental health professionals in Israel know and think about adolescent problem gambling

Mental health professionals are well versed in addressing multiple adolescent risky behaviours and play a primary role in the identification of and referral process and service provision for young people who engage in such behaviours. Given their ‘person-in-environment’ approach, training in multi-sectoral collaboration, and awareness of social policies, social workers are especially equipped to provide needed mental health services to young people. The aim of the current study was to examine Israeli mental health professionals’ awareness of and attitudes towards adolescent high-risk behaviours, including gambling. Child psychologists, social workers and school counsellors (N = 273) completed an online survey addressing concerns related to high-risk behaviours. Findings revealed that social workers perceived gambling as being among one of the least concerning adolescent mental health issues and reported feeling the least confident in their abilities to provide services to young people with gambling problems. The results suggest the importance of youth gambling addictions being incorporated into social work training curricula.