A Comment on 'Family Structure as a Factor in the Adjustment of Adopted Children'

Summary Dr. Kraus's paper¹ suggests that ‘a criterion of acceptabilityof childless applicants for adoption should be their childbearingpotential’. This proposal, with its extremely seriousimplications for practice, is based on the results of a questionnairesurvey of couples who had adopted babies seven years earlier.Failings in the statistical analysis, however, cast considerabledoubt on the main finding.     

Un-charted Territory? Experiences of the Purchaser/Provider Split in Local Authority Children's Services

¹Ian Kirkpatrick Public Services Research Unit. Cardiff Business School, Aberconway Building, Colum Road, Cardiff CF1 3EU, UK. Summary A primary goal of Conservative government policy, expressedin the 1990 National Health Service and Community Care Act,was to encourage the development of market mechanisms throughthe separation of purchaser and provider roles. The main targetfor reform was to be adult services although, in the absenceof specific guidance, a number of local authorities also implementedpurchaser/provider structures in services for children and families.To date, little attention has been given in the literature eitherto describing what purchaser/provider structures involve inthis context or to assessing their impact. Drawing on case studydata from seven local authorities, this article seeks to addressthese deficiencies. It is argued that many changes have beencosmetic and that, while it is not possible to evaluate thelong-term effectiveness of the model, there is evidence thatit can have some negative consequences for the co-ordinationand delivery of services.     

Consistency: a pre-requisite for inspecting old people's homes?

Correspondence to Dr Ian Gibbs, Centre for Housing Policy, University of York, Heslington, York YO1 5DD. Summary Inspection of old people's homes, in both local authority andindependent sectors, forms a major component in the work ofthe new ‘arm's length‘ inspection units. The successof these units will depend in part on inspectors' ability tomake consistent judgements based on agreed standards. This articlereports on a study which examined the extent to which inspectorswere able to reach reliable conclusions about the quality ofcare in old people's homes and the possible contribution ofchecklists in this task.     

The Social Work Role in Assisted Conception

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

The Effectiveness of an Out-Patient After-care Group with Previously Hospitalized Alcoholics

Summary The importance of after-care for alcoholics has been emphasizedby the Alcoholic Sub-Committee of the World Health Organization.¹Many writers have stressed this view and some have even attributedrelapses to the lack of vigorous after-care (Vallance, ² Rathod³).This paper reports an appraisal for a fortnightly group after-careservice for alcoholics which was established as an adjunct tothe ongoing treatment programme of an alcoholic unit. Data werecollected to provide some evaluation of the new service.     

The Use of a Modified Repertory Grid Technique for Assessing the Self-Concept of Children in Local Authority Foster Care

Dr. C. Hicks, School of Continuing Studies, University of Birmingham, P.O. Box 363, Birmingham, B15 2TT. Summary Two studies were carried out using a modified form of the repertorygrid technique to investigate the self-esteem of children inLocal Authority Care. The aim of the first study was to comparethe self-perceptions and self-esteem of Children in Local AuthorityCare with a group of matched controls. Two groups of ten subjectswere given a modified repertory grid task, which involved presentingeight pictorial elements and eight bipolar constructs, and askingthe subjects to rank order the elements according to their perceptionof each construct. The results indicated that children in Local Authority Carea) have significantly lower self-esteem scores (t=2.25, p<0.025)and b) have significantly fewer positive constructs about themselvesoverall (X²=7.07. p<0.01). The second study used a correlational design and looked at therelationship between the number of caretaker changes and self-esteem,in a single further group of eleven children in Local AuthorityCare. The same technique for assessing self-esteem was used as inStudy 1. The results showed a significant negative correlation(r=–0.638, p<0.025) suggesting that the more movesa child experiences, the lower the self-esteem is likely tobe. The results of both these studies are discussed in terms oftheir implications for Local Authority Child Care policy andfor the use of the repertory grid technique as a procedure forassessing self-esteem.     

Two Value Positions in Recent Child Care Law and Practice

Summary This paper aims to explore two contrasting viewpoints on stateand agency intervention in child care, and the major pointsof divergence and similarity between these viewpoints. Materialis drawn from literature and from interviews conducted by theauthor with individuals prominent in the child care field.¹Simply put, one viewpoint emphasizes the prevention of the break-upof ‘natural’ or biological families and the restorationof biological ties where severed, while the other advocatesthe readier removal of children from natural families and theprovision of permanent, secure substitute families when naturalparenting is unsatisfactory. At attempt is made to place thesetwo positions in a wider intellectual context.     

Which Children are Registered at Case Conferences?

Correspondence to Terry Fisher, Department of Social Policy and Social Work, University of York, Heslington, York YO1 5DD. Summary A postal questionnaire to social workers was used to describethe characteristics of situations where children were the subjectsof child protection case conferences, to identify factors distinguishingthose registered from those not registered and to describe theaccounts given by social workers of the reasons for registration.The paper reports and analyses this information and raises somebasic issues about the relative importance in registration decisionsof evidence of physical or sexual abuse, characteristics ofthe adults involved, and a child's feelings and emotional state.     

Quality Indicators: Disabled Children's and Parents' Prioritizations and Experiences of Quality Criteria when Using Different Types of Support Services

Correspondence to Dr Wendy Mitchell, Social Policy Research Unit, University of York, York YO10 5DD, UK. E-mail: wam1{at}york.ac.uk Summary Current health and social care policy seeks to develop and refinestandards of service quality. However, policies have so farlargely focused upon statistically based service output indicators.Recognizing the importance and yet limitations of this, especiallyin services for disabled children and their families, this paperdraws upon qualitative and quantitative data to explore indicatorsthat are meaningful and relevant to disabled children and theirfamilies. Results demonstrate the need to look beyond a genericfamily-based perception of service quality, as children andparents value different aspects of service quality and prioritizedifferent indicators when using different types of services.Although some indicators are regarded as ‘core’quality indicators, irrespective of service type, others areonly prioritized for specific types of services.     

Adolescents in Care and their Social Workers: A Research Note

Summary There has recently been an increasing concern that young people,and especially those in residential care, should be encouragedto express their views, and that the views expressed shouldbe used in improving the care which they receive. The publicationof the Who Cares? booklet (Page and Clarke¹), and the emergenceof ‘Who Cares’ groups and the ‘Voice of theChild in Care’ organisation, is evidence of this concern.In sympathy with these developments has been a study of adolescents'perceptions of social workers, and a part of this research hasincluded a pilot study of the views of adolescents living intwo family group homes.     

Helping Children Directly

Summary The mothers most able to respond to the child's communicationsare those whose personal needs do not obtrude and who have onlya minimum of preconceived ideas. Thus they are able to considerthe child as an individual and are interested in his expressionof individuality. They want to listen and to understand andenjoy the flow of communication between him and them. (Heinickeand Westheimer¹)     

Placing Children on Child Protection Registers: Risk Indicators and Local Authority Differences

Correspondence to Dr David Gordon, School for Policy Studies, University of Bristol, 8 Woodland Road, Bristol BS8 1TN, UK. Summary Wide variation in rates of children on protection registersin different authorities has led to doubts about the reliabilityof local decision making. A study of 1,752 referrals, for suspectedabuse or neglect in eight English local authorities, found thatindicators of child and family vulnerability were more importantthan local area in explaining selection for initial child protectionconference and placement on registers. There appeared to beagreement on ‘common-sense’ risk indicators butstronger measurements of risk would enable child protectionprocedures to be better targeted.     

Dangerous Clients: Further Observations on the Limitation of Mayhem

Correspondence to 1 Home Close Road, Houghton on the Hill, Leicester, LE7 9GT Summary The present contribution seeks to complement, up-date and amplifymaterial presented in an earlier paper in this Journal (Prins,1975) concerned with the management of dangerous and potentiallydangerous clients (in this case, offender-patients). An attemptis made to define the clientele considered to be at high riskof committing further acts of serious harm. Some brief observationsare made upon the nature of dangerous behaviour and risk. Theauthor then examines in more detail those factors and circumstancesthat may lead to the repetition of such behaviour and offerssome suggestions for its reduction. The paper's orientationis clinical rather than empirical or epidemiological.^{1, 2}     

The Psychiatrization of Post-Traumatic Distress: Issues for Social Workers

¹Howard Davis, Centre for Studies in Crime and Social Justice, Edge Hill, St Helens Road, Ormskirk, Lancashire L39 4QP, UK. Summary The psychiatric category of post-traumatic stress disorder (PTSD)is described and critiqued. Problems of definition and applicationmay lead to the non-inclusion or minimization of some formsof post-traumatic distress. Questions of what constitute ‘healthy’and ‘unhealthy’ reactions to trauma are raised andthe depoliticization of trauma explored. The absence from theliterature of sufficient acknowledgement of traumagenic actionson the part of official agencies is noted. The potential forcritically informed social work interventions in prevention,mitigation and longer-term response is outlined.     

The Vulnerabilities of Children whose Parents have been Sexually Abused in Childhood: Towards a New Framework

Correspondence to Carol-Ann Hooper, Department of Social Policy and Social Work, University of York, Heslington, York YO10 5DD, UK. E-mail: cah13{at}york.ac.uk Summary Concerns about the parenting capacity of adults with a historyof childhood sexual abuse have often been framed in individualizingand pathologizing ways. This paper draws on qualitative researchwith twenty-four women survivors of childhood sexual abuse todevelop a new framework for understanding the possible vulnerabilitiesof their children that may help inform anti-oppressive practice.The framework places the mother-child relationship in its broadercontext, taking account of the role of the immediate family,the extended family, the community and the state. Within eachlevel of context we identify the range of issues that couldcontribute to children’s vulnerability, elaborating theprocesses involved. Some issues recur within different contexts,for example the impacts of survivors’ issues around attachment,and others connect across contexts, such as the impact on childrenof deterioration in their mothers' mental health when appropriateservices are not available. All of these issues may affect survivors’well-being and access to social support and hence their abilityto care effectively for their children. Ways of supporting bothsurvivors and their children involving greater collective responsibilityfor children, effective collaboration between mental healthservices and child-care services, and professional responseswhich take account of contextual issues are identified.     

Matches and Mismatches: The Contribution of Carers and Children to the Success of Foster Placements

Correspondence to Professor Ian Sinclair, Social Work Research and Development Unit, University of York, York YO10 5DD. E-mail: acs5{at}york.ac.uk Summary Data were collected on 472 foster children at an interval of14 months. The children's social workers, the family placementsocial workers and the foster carers reported on disruptions,and the reasons for placement success or lack of it. These views,combined with comments from the children, led to hypothesesabout the origins of successful placements. Statistical testsof these hypotheses suggested that success depended on threeaspects of the placement. First of these was the children'scharacteristics. Children, who wanted to be fostered (had attractivecharacteristics and low levels of disturbance), did better.Second were the qualities of the foster carer. Placements withwarm, child-oriented carers were more successful. Third wasthe interaction between carer and child. The findings emphasizethe crucial importance of the foster carers to outcomes. Theyalso support the need to pay close attention to children's views,and the potential importance of early intervention to preventnegative spirals of interaction between carer and child.     

Culture Religion and Infertility: A South African Perspective

¹ Dr Vishanthie Sewpaul, Department of Social Work, University of Natal, Durban 4041, South Africa. E-mail: sewpaul{at}mtb.und.ac.za Summary This paper contains data pertaining to cultural views on fertilityand infertility, and the use of traditional healing in infertility,from a sample of twenty-four case studies of infertile participantsand from twelve religious leaders representative of the faithsof the infertile participants. This is followed by a discussionon the impact of religion on the handling of infertility. Theunique differences between the Indian and African world viewscompared with those of Coloureds and Whites² are evident. However,the impact of religion on the handling of infertility reflectssimilarities across different religious groups. Within the variousthemes that emerged regarding religion and infertility, themost pervasive, across all religious faiths, was that infertilitywas seen as punishment for wrong-doing. The individual's levelof involvement with religion, their personal conception of God,and their sense of self in relation to God appeared to be importantfactors in influencing the impact of religion on the experienceof infertility.     

Adopted Children in Care

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

No-one else could understand': Women's Experiences of a Support Group run by and for Mothers of Sexually Abused Children

Summary Previous studies have shown that when a woman finds out aboutthe sexual abuse of her children the consequences for her areserious and can represent a major life crisis. Women in thisposition frequently report a lack of professional understandingand support. The current study explores the experiences of women attendinga busy peer support group at the NSPCC in York. It demonstratesthe vital role that peer support can play. It traces a varietyof factors which mean that family, friends and social workersare not well placed to help. At the heart of these difficultiesare the powerful feelings of guilt and failure in their roleas mothers which the women experienced as a result of the sexualabuse of their children. For these women it was impossible toshare with social workers their doubts about their own abilitiesas mothers, particularly in a context in which those workerswere making judgements about their ‘ability to protect’.On the other hand the support group provided a safe and non-judgementalforum in which these powerful emotions could be expressed anddealt with. The study explores the role that social workerscan play in relation to such groups.