Identifying Children's Needs When Parents Access Drug Treatment: The Utility of a Brief Screening Measure

SUMMARY

This study evaluated whether a brief screening measure of child psychosocial functioning completed by parents could assist drug and alcohol workers to identify which of their client's children needed follow-up support. As part of a broader research and intervention program for 4–13 year old children with substance dependent parents, the Strengths and Difficulties Questionnaire (SDQ) and a broader clinical assessment were completed with the families of 48 children. Validating its usefulness in this population, significant and moderate correlations were found between SDQ scores and workers' assessments of children's social, emotional, and cognitive development and schooling.     

Caregivers' Endorsement of Barriers to Mental Health Services for Children and Youth in Child Welfare

The purpose of this study was to examine the three most common types of caregivers in the child welfare system (birth parents, relative caregivers, and foster parents), an active child welfare case, caregivers' endorsement of barriers to mental health services and mental health service use by caregivers for the children under their care. The sample consisted of 430 dyads (caregivers and their children). Results indicate that an active child welfare case, provider characteristics, and accessibility of services predicted mental health service use for children. Implications for the child welfare and mental health systems are discussed.     

The Youngest Victims of Violence: Examining the Mental Health Needs of Young Children Who Are Involved in the Child Welfare and Juvenile Justice Systems

Children placed in the state’s custody due to neglect, abuse or maltreatment are one of America’s most vulnerable populations. Seventy-five percent of child victims of maltreatment are under the age of 12. Not only is their suffering a problem, these children are also at increased risk for delinquent behavior later in life. While research has documented the potential long-term consequences of child abuse and neglect, the mental health needs of young children involved in the foster care and juvenile justice systems have been largely overlooked. This study examined the social, emotional and behavioral difficulties of 670 children, age 3–11, who were involved in the child welfare and juvenile justice systems. Children in this study were living in residential treatment facilities, group homes, foster care homes or were receiving intensive home-based services. To assess the children’s mental health needs caregivers completed the parent form of the Strengths and Difficulties Questionnaire (Goodman, Journal of Child Psychology and Psychiatry 38:581–586, 1997). The findings indicated a high prevalence of mental health problems, with 81 % of the children in the sample having a total difficulties score in the borderline or abnormal range and 90 % of the children having borderline or abnormal scores on at least one of the subscales (conduct, emotional, peer or attention problems). When characteristics such as gender, race and age were considered significant differences were found among boys and girls, Caucasian and minority children, and age groups. The findings highlight the importance of mental health assessment and interventions that are gender and culturally sensitive and developmentally appropriate.     

Mental Health and Behavioral Outcomes of Sexual and Nonsexual Child Maltreatment Among Child Welfare-Involved Youth

Our research team used the nationally representative National Survey of Child and Adolescent Well-Being II to explore the differences in mental health and behavioral outcomes between children who enter the child welfare system with substantiated sexual abuse and those who enter with exclusively nonsexual maltreatment. The sample included 380 children between the ages of 8 to 17.5 who were substantiated for maltreatment (sexual and nonsexual) and had the same caregivers at both wave 1 and 2 (n = 380). Results show that the average age of children in the sample was 11 years old, and the results corroborate literature that has indicated children and youth with histories of childhood sexual abuse experience significantly more post-traumatic stress disorder symptoms than children with histories of nonsexual maltreatment. This finding held after controlling for baseline trauma symptoms and all covariates, including race, age, placement type, and caregiver characteristics. Childhood sexual abuse was not significantly related to an increase in behavioral symptoms after controlling for covariates. Implications for research and practice are offered.     

Making Decisions about Parental Mental Health: An Exploratory Study of Community Mental Health Team Staff

Adult mental health problems can impact on parents, and research highlights that their children are at higher risk of developing mental health problems. In extreme cases, mental health problems are associated with a risk of fatal child abuse. Despite this, there are few studies exploring clinical decision‐making by adult mental health professionals.

‘In extreme cases, mental health problems are associated with a risk of fatal child abuse’

This study used qualitative methods to explore Community Mental Health Team (CMHT) workers' experiences of decision‐making in the interface between mental health and child welfare. Workers were interviewed about their experiences of clinical decision‐making regarding child welfare. Interviews and accounts were analysed using Interpretative Phenomenological Analysis. Influences on decision‐making were explored and triangulated with the accounts of Named Nurses for Child Protection. The findings revealed that CMHT participants were aware of their responsibilities towards children, but a complex synthesis of factors impacted on their sense‐making about risk and welfare. Three superordinate themes emerged: the tensions of working across systems; trying to balance the perceptions and feelings involved in sense‐making; and the role that interpersonal dynamics play in the understanding and management of risk. This paper focuses in particular on perceptions and feelings. Copyright © 2011 John Wiley & Sons, Ltd.

‘A complex synthesis of factors impacted on their sense‐making about risk and welfare’

Citing Literature

Number of times cited according to CrossRef: 8

• Natalie Elizabeth Anderson, Julia Slark, Merryn Gott, Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making, Journal of Research in Nursing, 10.1177/1744987118809528, 24 , 1-2, (88-101), (2019). Crossref
• Phillip Tchernegovski, Andrea E. Reupert, Darryl J. Maybery, How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study, Child & Family Social Work, 10.1111/cfs.12426, 23 , 3, (381-389), (2017). Wiley Online Library
• Maria Afzelius, Lars Plantin, Margareta Östman, Children of Parents With Serious Mental Illness: The Perspective of Social Workers, Practice, 10.1080/09503153.2016.1260705, 29 , 4, (293-310), (2016). Crossref
• Louise Everitt, Caroline Homer, Jennifer Fenwick, Working with Vulnerable Pregnant Women Who Are At Risk of Having their Babies Removed by the Child Protection Agency in New South Wales, Australia, Child Abuse Review, 10.1002/car.2432, 26 , 5, (351-363), (2016). Wiley Online Library
• Joe Duffy, Gavin Davidson, Damien Kavanagh, Applying the recovery approach to the interface between mental health and child protection services, Child Care in Practice, 10.1080/13575279.2015.1064358, 22 , 1, (35-49), (2015). Crossref
• Peter Sidebotham, What did you do at Work Today, Daddy?, Child Abuse Review, 10.1002/car.2357, 23 , 5, (307-310), (2014). Wiley Online Library
• Peter Sidebotham, Rethinking Filicide, Child Abuse Review, 10.1002/car.2303, 22 , 5, (305-310), (2013). Wiley Online Library
• Jane V. Appleton, Peter Sidebotham, Child Protection and Mental Health, Child Abuse Review, 10.1002/car.2220, 21 , 3, (153-156), (2012). Wiley Online Library

Volume 21 , Issue 3 May/June 2012

Pages 173-189     

Parental Divorce and Child Mental Health Trajectories

A process‐oriented approach to parental divorce locates the experience within the social and developmental context of children's lives, providing greater insight into how parental divorce produces vulnerability in some children and resiliency in others. The current study involves prospectively tracking a nationally representative sample of Canadian children of ages 4–7 and living with two biological parents at initial interview in 1994 (N = 2,819), and comparing the mental health trajectories of children whose parents remain married with those whose parents divorce by 1998. Results from growth curve models confirm that, even before marital breakup, children whose parents later divorce exhibit higher levels of anxiety/depression and antisocial behavior than children whose parents remain married. There is a further increase in child anxiety/depression but not antisocial behavior associated with the event of parental divorce itself. Controlling for predivorce parental socioeconomic and psychosocial resources fully accounts for poorer child mental health at initial interview among children whose parents later divorce, but does not explain the divorce‐specific increase in anxiety/depression. Finally, a significant interaction between parental divorce and predivorce levels of family dysfunction suggests that child antisocial behavior decreases when marriages in highly dysfunctional families are dissolved.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

Divorce and Family Structure in Norway: Associations With Adolescent Mental Health

The aim of this study was to examine the association between family structure and adolecent mental health, after the considerable increase in divorced parents choosing joint physical custody (JPC) in Norway. Data stem from the youth@hordaland study, a population-based survey conducted in Norway in 2012. A total of 7,707 adolescents (47% male) 16 to 19 years old were included in this study. The adolescents were classified into 6 family structures. Mental health was measured using the Strengths and Difficulties Questionnaire (SDQ). No significant differences between nondivorced families (reference) and JPC were observed. Adolescents from single-parent and stepfather families scored significantly higher on all 3 SDQ scales, and adolescents from stepmother families scored significantly higher on the SDQ total and SDQ externalizing scales. In conclusion, the results of this study indicated that adolescents living in JPC did not have more adjustment problems compared to their peers living in nondivorced families.     

Diversion From the Juvenile Justice System: Observations of a Teen Court Program

Teen courts are a multidisciplinary intervention used to divert youth with minor offenses from the juvenile justice system. Observations were conducted at 13 hearings in an urban jurisdiction, with information gathered about the youth respondent, peer jurors, and adult volunteers. Peer jurors engaged in the majority of communication with the respondent during hearings. Adult volunteers, often members of the legal or judicial community, fulfilled supporting functions. Findings suggest that a youth-oriented process with support from adult volunteers can result in active participation from youth, and that teen courts provide opportunities for community involvement.     

Mental Health Knowledge Gaps in the Child Protection Work with Parents: A Narrative Review of the Social Work Literature

This is a narrative review of the latest peer-reviewed social work literature on the child protection work with parents. Aiming to identify knowledge gaps, the study researches the mental health aspects of the implicit or explicit theoretical perspectives underpinning the assessment and intervention with parents. An electronic database search extracted 38 peer-reviewed journal articles. It was found that the theoretical perspectives the publications adopted were the managerial, the critical, the humanistic, the psychodynamic and the behavioural. The study identified mental health knowledge gaps in the assessment and intervention work with parents across all theoretical perspectives and stressed the need for process and effectiveness studies on the work with parents, under explicit theoretical perspectives. The study finally highlights the need for the social work profession to increase its mental health literacy through mental health education for students and practitioners alike.     

Balancing Justice and Welfare Needs in Family Group Conferences for Children with Harmful Sexual Behavior: The HSB-FGC Framework

In England and Wales, family group conferences (FGCs) are most often found either in the field of youth justice or in the field of child protection, and consequently often have priorities in line with either one of the two systems. On the one hand, FGCs are a restorative justice tool to address offending behavior and hold young perpetrators to account, while giving victims the possibility of contributing to the justice process. On the other hand, FGCs address safeguarding concerns and are used to plan for child safety and protection. In cases where a young person has sexually harmed another young person, that is, has perpetrated harmful sexual behavior (HSB), all young people involved will have both justice and welfare needs. FGCs are emerging as promising mechanisms in such cases, not only because of their ability to deal with both sets of needs for both young people but also because of their potential to address more holistic needs. However, HSB cases are often complex and sensitive, and are not without risk. Drawing on their experiences in research and practice, the authors explore how the holistic needs of both the harmed and harming individual can be balanced within a risk managed HSB-FGC framework.     

Parent Management Training, Relationships with Agency Staff, and Child Mental Health: Urban Foster Parents' Perspectives

Many foster parents are ill prepared to meet the behavioral needs of children placed in their homes. Research suggests they lack training in evidence-based behavioral interventions and feel unsupported by child welfare professionals. Given the complex needs of foster children and increased rates of placement disruption for foster children with behavior problems, implementation of effective interventions is essential. However, little is known about foster parents' receptivity to these types of interventions. In this qualitative study, we examine urban foster parents' perceptions of the specific elements of parent management training (PMT), an evidence-based treatment for disruptive behaviors that teaches parents to improve desired behaviors and decrease oppositional behaviors by rewarding positive behaviors (positive reinforcement) and responding to negative behaviors with mild, consistent punishments such as timeout or a privilege removal. We present data from four focus groups (N = 38). While the questions focused on parent's perceptions of PMT, responses often related to parent interactions with agency staff. Four strong themes emerged from the data. First, foster parents discussed a need for more support and training in how to address children's behaviors, but also had concerns that some PMT discipline techniques would be ineffective based on their past experiences with foster children. Second, they described how staff communication skills and allegations of child abuse could affect parents' motivation to continue fostering. Third, they expressed a need for more detailed information about children's histories and visits with biological families as the lack of information contributed to difficulty in meeting foster children's needs. They suggested that joint training of foster parents and staff in the intervention could improve their ability to work together to support the child's positive behaviors. Finally, parents reported little involvement in child mental health services and doubted the effectiveness of the mental health services their foster children received.     

A Child and Adolescent Mental Health Day Program Working at the Edge of Chaos: What Complexity Science May Tell Us About Team,Family and Group Systems

The purpose of this article was to explore the potential application of the science of complexity to aspects of team, family and group systems. A child and adolescent mental health Day Program as a tightly knit multidisciplinary team closely interacting with family systems, provides an opportunity to illustrate concepts of this general scientific framework and offer potentially unique insights. In particular, the relevance of diversity and interconnectivity between parts of a system are highlighted. Ideas explored include team functioning, how change occurs in families and new ways of looking at groups. Furthermore, complexity provides support for intensive multisystemic interventions such as the Day Program to assist families with severe and chronic child mental health issues.     

Parenting with a Disability and Child Mental Health: A Propensity Score Analysis

Little research has examined the impact of having a parent with a disability on child mental health. This study used data from 7,116 families of children who participated in the 2006 National Health Interview Survey and propensity score matching (PSM) to investigate this question. Prior to PSM, differences in Child Mental Health Brief scores were significant with a moderate effect size. After PSM, differences in Child Mental Health Brief scores were still significant, but the effect size was small. Results indicate that much of the mental health risk for children of parents with disabilities is connected to related issues.     

A National Survey of Child Advocacy Center Directors Regarding Knowledge of Assessment,Treatment Referral,and Training Needs in Physical and Sexual Abuse

Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study.     

Hurdling the Artificial Fence Between Child Welfare and the Community: Engaging Community Partners to Address Disproportionality

As with many national and state social service systems, child welfare agencies have traditionally functioned in isolation. A multitude of federal and state laws and policies direct the functions and practices of child welfare systems, setting up an artificial fence around the agency that has created a culture lacking in interprofessional collaborations. However, recent reform efforts have emphasized the importance of engaging the community in discussions and decisions regarding child welfare practice. Child welfare agencies are now expected to work with community leaders, key stakeholders, affiliated service providers, and families to address issues impacting children and families. A major obstacle is determining where to begin, how to proceed, and what is needed to develop those partnerships. This article reports the efforts of one state agency in hurdling that artificial fence to address the overrepresentation of minority children in the system. Through focus group interviews with community members, child welfare staff, and legal professionals, barriers to community engagement are identified, and recommendations are provided for facilitating meaningful relationships and partnerships between child welfare agencies and the communities they serve.     

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

Early intervention in childhood years is an important part of successful therapies for children and adolescents living with or at risk of mental illness. Family therapy acknowledges the role of family relationships, interactions, and family systems in child and youth mental health. To explore the effectiveness and delivery of family therapy in order to inform current family therapy practice in Australian public mental health services, a scoping literature review mapped key concepts of the past 11 years of family therapy research. Current gaps were noted within the following key concepts: family therapy settings and definitions, the influence of family factors on outcomes, transparency of intervention methods, and the training of family therapists. Further research could be undertaken to address current gaps in the literature, specifically: assessment and intervention processes; typical length of time for a series of family sessions; frequency of sessions; and theoretical foundations linked with most effective outcomes, as identified by clinicians, children, and their families. This research would provide a better understanding of best practice and evidence‐based family therapy practices that work for children and their families to inform family therapy practice in Australia and beyond. This scoping literature review identified that there is a noteworthy variation in the way brief family therapy is provided, both in terms of the duration and frequency of sessions, as well as the theoretical underpinnings employed. Further research is warranted to explore different service contexts and brief versions of family therapy delivery and the outcomes for the children and their families.     

Sharing the Baton,Not Passing It: Collaboration between Public and Private Child Welfare Agencies to Reunify Families

ABSTRACT

Increasingly, public sector child welfare agencies are contracting with private agencies for the provision of specialized services to clients while maintaining oversight and case management responsibilities. At the same time, funders, both private and public, are demanding that service providers partner and collaborate with one another. In this article, we present results from a study of a unique partnership between two state child welfare agencies and a private child welfare agency aimed at reunifying families whose children have been removed and placed in foster care. Data was obtained from 41 key informants using a questionnaire and a structured interview. Findings support earlier studies of collaboration, and indicate the strengths of this partnership and factors that facilitated and hindered it. The results have implications for agencies that both contract for and provide a range of child welfare services as well as other interagency relationships.     

The Evolution of Mental Health Care Policy and the Implications for Social Work

Abstract

The focus of this article is on the evolution of mental health care policy in the United States from the eighteenth century to the present. To the extent that social work practice enacts policy, this article focuses particularly on the ways 20th century social workers have reflected, interpreted, and forged mental health care initiatives and reforms. The article includes a discussion of how the cycles of mental health reform (moral treatment, mental hygiene, and community mental health) have influenced not only the roles but also the actual practices of social workers. The article concludes with a consideration of the impact of managed care on mental health policy and the implications for social work.     

On the Front Lines: The Voices and Experiences of Racialized Child Welfare Workers in Toronto,Canada

Drawing on focus group data highlighting the perceptions and experiences of racialized child protection workers in the Greater Toronto Area, this article explores the ways in which race operates in the Ontario child welfare system. Most study participants experienced the agencies in which they worked as White-normed environments characterized by systemic racial discrimination in promotion and advancement as well as ongoing instances of racial microaggression—common, everyday practices that denigrate people of color. Several participants spoke of having to contend with White-normed and middle-class-oriented policies, tools, and practices that often prevented them from meeting the unique needs of racialized service users. The article concludes with participants' recommendations for creating a more equitable child welfare system.