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.     

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.     

The rise of market-based “choice” programs: 100 years of social sorting in social welfare services

Social service programs in the United States increasingly focus on giving individuals and families more “choices.” The approach is exemplified by “choice programs,” where people receive services through various forms of market participation. Examples of choice programs include defined contribution retirement plans, housing vouchers, charter schools, and health insurance marketplaces. Individuals across the socioeconomic spectrum have become accustomed to choice programs, and one's social status greatly affects the types, qualities, and prices of services people receive. The importance of the conversation around choice programs for providing access to resources is immense. Yet, despite contentious debate about their utility, we lack a comprehensive understanding of the institutionalization and widespread adoption of choice programs across a diverse range of social service domains. This article synthesizes stratification literature on retirement, healthcare, education, and housing to document the historical rise of choice programs. Particular attention is given to explaining how behavioral patterns and routines become second nature, altering who benefits, who is left out, and the overall effectiveness of the social welfare system.     

Lost in Translation? Embracing the Challenges of Working With Families From a Refugee Background

This article describes the difficulties a mainstream family therapy service experienced in working with families from a refugee background. The experience of six therapists and five bicultural workers, who are also the referring agents, was captured in focus groups, and the reflections that emerged shaped a four‐part approach for working with families from a refugee background. Live consultation, either by the family therapist or bicultural worker, is suggested as a way to marry the expertise of family therapists who are not cultural ‘insiders’ with the ‘lived experience’ and cultural expertise of bicultural support workers. The process of reflecting on therapeutic failure resulted in several principles for working therapeu‐tically with families with a history of refugee trauma, unmet resettlement needs and family relationship challenges. These include maintaining a flexible approach to therapy, ascertaining a clear understanding of the referral context, defining an explicit therapeutic contract from the first session, being mindful of the important role that language plays and terminating therapy if it is contra‐indicated.     

A Partnership Model for Family Service Agencies and Universities to Improve Service Utilization

ABSTRACT

Partnerships between family service agencies and universities have the potential for capitalizing on the resources and expertise of both types of institutions. This paper describes a model for developing collaborative partnerships between family service agencies and outreach research university programs. The original collaboration that is used as an example for this model sought to improve the engagement rates of reluctant families being referred to a family service agency for counseling services. Benefits and potential pitfalls to be addressed in such partnerships are presented.     

Families' Values and Attitudes Regarding Responsibility for the Frail Elderly

Abstract

This study examines the norms and values associated with care to disabled and frail aging parents, in particular those with regard to the sharing of responsibilities for care between families and formal services, and this within three age cohorts in Quebec, Canada. It is based on a telephone interview of 1,315 people. Factor analysis yielded four factors: (1) family responsibility; (2) uncompromising family obligations; (3) acceptance of services; (4) distrust of services. Analyses of the data indicate that all three age cohorts consider that families have responsibilities for their aging family members, at the same time that they score very high on the acceptance of service scale. This article discusses these seemingly paradoxical results and their implications for aging policy.     

How do you solve a problem like Maria? Family complexity and institutional complications in UK social work

ABSTRACT

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers’ conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family’s situation in terms of the range of issues identified and candidate ‘causes’. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies’ involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning.     

Unmet service needs of families of young children with chronic illnesses and disabilities

Data about health and educational services were collected from 187 families with young children (under two years) who have chronic illnesses and disabilities. The purpose was to assess parents' satisfaction with services their families received and to identify families' unmet service needs as well as the reasons for these unmet needs. Although families' ratings of the adequacy of services are relatively high, 28% of the families report unmet service needs. The unmet needs most often reported are occupational, physical, or speech therapy; respite care/child care; and special education. Lack of funding is the most commonly given reason for unmet needs. Children with multiple impairments are at highest risk for unmet needs. Only 22% of unmet needs reported at the initial interview have been met by the time of the six-month follow-up. Increased coordination and monitoring of services across service sectors are indicated. Her research interests include the effects of disability on family identity and families' responses to minority stress. She received her Ph.D. from the University of Minnesota. She gratefully acknowledges Shelley Blazis and Nadav Casuto for statistical consulting. Her research interests focus on the impact of chronic illness and disability on families. She received her Ph.D. from the University of Minnesota. Her research interests include families and health and chronic illness and disability in children. She received her Ph.D. in Family Social Science at the University of Minnesota. His areas of interest include neurodevelopmental outcomes of low birth weight infants and training in developmental pediatrics. He was graduated from the University of Minnesota Medical School. His areas of interest include adolescents with chronic illness and disabilities, adolescent sexual decision making, and international adolescent health care issues. He was graduated from Howard University College of Medicine was awarded his earned doctorate in Health Policy from the University of Minnesota. Preparation of this article was supported by the National Institute on Disability and Rehabilitation Research Grant #H133890012.     

Family Unity Meetings: Decision Making and Placement Outcomes

ABSTRACT

The sample consisted of all families (747) who were invited to receive a Family Unity Meeting from a Public Child Welfare Agency in a large urban county. Data was derived from the review of agency case files. The design was a retrospective case review with an embedded prospective study. This study describes factors that distinguish between CPS clients who accept an invitation to participate in a Family Unity Meeting (FUM) and those clients who decline to participate. The meeting process is described, and logistic regression is used to identify variables that predicted successful outcomes FUM meetings.

Families with reunification as a goal were the most likely cases to agree to participate followed by Voluntary and Permanency Planning cases. Cases with severe neglect were the least likely group to participate in a meeting process. Approximately nine people attended an average meeting. Maternal relatives were more likely to attend than paternal relatives.

Empirical evidence was found to support the notion that FUM expands the notion of family. Only 38% of children were placed with a parent after a meeting, but 82% of children were placed with a family member. Children were not placed with either the parent or family if the social worker had placement as a goal before the meeting. Cases with permanency plans were also less likely to be placed with the family. Social workers were more likely to agree with a placement with relatives if they had a concern about parental drug abuse. Having a maternal aunt in attendance at the meeting was predictive of having a child placed with the family.

Social workers and families stated concerns prior to the meeting diverged. Families were more concerned with economic and financial issues than were the social workers. Social workers were more concerned with child protective service issues (type of abuse, placement issues, etc.) and the behavior of the parent (substance abuse, mental health, etc.) than was the family. Paying attention to family issues such as finances may be a necessary precursor to families focusing on more complex matters like substance abuse or parenting practices.

Placement outcomes were consistent with worker's goals stated before the meeting. If a social worker said they wanted to place a child with the family before the meeting, that placement was most likely the outcome of the meeting. Social workers may be guiding the decisions of the family. If this interpretation is correct then it raises questions about who makes decisions at the meeting. An alternative conclusion is that the social workers are good diagnosticians who know prior to the meeting if placement is necessary, and know what decisions the family will make.     

Family Resilience Predicts Socioeconomic Mobility of HUD Participants

Changing economic times and government policies are reshaping the way the U.S. Department of Housing and Urban Development (HUD) provides services nationwide; there is both a growing demand for housing and a desire to help families become self-sufficient. In this study, the authors examined factors that contribute to increased socioeconomic mobility through the lens of family resilience. Analyzing cross-sectional data from 411 families in the San Bernardino County HUD District using discriminant function analysis, results of this study show strong preliminary evidence that certain components of family resilience predict whether an individual head of household will have full-time employment. The results of this study provide implications for social service programs aimed at socioeconomic mobility.     

Are services to prevent foster care effective?

The prevention of foster care became an important issue for child welfare services during the 1970s. Two main types of prevention models have emerged: crisis intervention programs intended to prevent imminent placement and intensive service programs designed to avert those crisis situations that precipitate placement. A critical analysis of several project evaluations leads to the conclusion that neither model has been markedly successful. Low nominal project placement rates seem attributable to inability to predict placements and to client selection biases. From a strictly financial perspective, preventive services have been considerably more expensive than regular services, including temporary family foster care. Data from a new demonstration project in New Jersey illustrate various problems in providing and evaluating preventive services to families referred to protective service agencies. Implications of the findings for prevention programs and policies are discussed, and a new direction focused on truly early intervention with children and families is proposed.     

Family Functioning Patterns as Predictors of Engagement: Which Families Participate in Services and Which Ones Do Not?

The present study examines the relationship between specific areas of family functioning and family engagement in prevention services. A sample of 147 families who initiated youth-centered treatment services from a non-profit agency was selected. Statistical analysis was used to test for relationships between family scores on the Family Assessment Measure (version III, General Scale) and family levels of engagement in services. Results of binary logistic regression analysis indicated that individual and family characteristics are associated with family engagement in services. In addition to demographic variables of age and race, family patterns of denial made a significant individual contribution to the evaluated model. Implications for engaging families in prevention services are discussed and suggestions are made for future research.     

The Family Outreach Model: Tools for Engaging and Working With Families in Distress

The purpose of this article is to present a family intervention model to family service providers that builds on previous research in areas of social support and family problem solving. The Family Outreach Model provides a set of strategies for engaging and working with families in five phases of family coping at different points in time in the family's life. The strategies reflect intentional choices by family service providers about both collaborative and directive styles of therapeutic alliance and highlights ways to determine which style best fits with what specific families want and need, depending on the manner of family coping that it is using. Implications for programs and public policy are presented.     

Broadening the Array of Services: Integrating Legal and Social Work Services for Youth and Families

ABSTRACT

The Community Justice and Legal Assistance Clinic (CJLA) is a unique community-based legal clinic developed through a partnership between a law school and a child and family service agency embedded within a low-income community. This article describes the development of this clinic through a community assessment process; its unique multidisciplinary features; the services provided to clients in three of the agency's service areas; the benefits of the partnership for clients, the social service agency, the participating law students, and the law school; and lessons learned for replication of this type of clinic in other communities.     

Understanding Client Communities Spatially for Developing Effective Interventions: Application of Geographic Information Systems (GIS) Technology for Program Planning in Health and Human Services Agencies

Social workers are better equipped to understand the need to incorporate geographical aspects pertaining to their clients’ lives as part of their practice, given the significant influence these factors have on client well-being. Geographic Information Systems (GIS) technology is a useful tool for administrators and planners to make informed decisions regarding human service programs including examining program outcomes and impact as well as streamlining program implementation. This article synthesizes the literature to date on GIS in health and human services with examples of real world applications.     

Implementing the family preservation program: Feedback from focus groups with consumers and providers of services

There is a growing understanding that preventative child welfare efforts can be both more cost effective and are more desirable philosophically than strictly remedial programs. The Family Preservation Act provides funds to assist communities in strengthening and preserving at-risk families. In order to implement this program effectively, local communities must design new programs and procedures which will be both attractive to consumers and effective in meeting their needs. This study it identifies problems with contemporary child and family services and suggests solutions to those problems. This study uses a focus group format and presents ideas generated by those individuals who will be most directly affected by this legislation; front line service providers and service consumers. Several areas of weakness in the current service delivery system are identified, including bureaucratic barriers, limited resources, problematic consumer/provider relations and a range of collaborative issues, both within and between agencies and the communities they serve.     

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.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Two decades of serving children with autism in the People’s Republic of China: achievements and challenges of a state‐run mental health center

This article presents the results of research conducted at the first place where autism was diagnosed in China, the Nanjing Child Mental Health Research Center. The purpose was to examine the development of service provision for children with autism in this state‐run medical institution. Specifically, the specific intervention model for autism, factors influencing the development of this model and how structural and organizational features of the institution impact on the implementation of that model are examined. Results indicate: (1) the importance of family involvement in intervention due to limited services in China; (2) the challenges of providing educational services at a medical institution during the reform period. The implications of these services in contemporary China are significant to consider as an important way to address the rights of individuals with disabilities to have equal opportunities in society, beginning with early education.