Care-leavers and their children placed for adoption

Young people in and leaving state care are more likely than the general population to become parents at a young age. Relatively little is known about the experiences and progress of care leaver parents and their children, but emerging evidence suggests an increased risk of intergenerational state intervention. Drawing on data from the Wales Adoption Study, this paper examines the prevalence and profiles of care leavers amongst birth parents whose children were placed for adoption. Findings showed that more than a quarter (27%) of birth mothers and a fifth (19%) of birth fathers with children placed for adoption were themselves care leavers. There were no significant differences between care leaver and non-care leaver birth parents in terms of involvement in crime or substance misuse, but carer leaver birth parents were distinguishable from other birth parents by their own experiences of abuse and neglect. Care leaver birth mothers were also more likely than their non-care leaver counterparts to have diagnosed mental health problems and were less likely to appeal the adoption plan. The profiles of children placed for adoption between care leaver and non-care leaver birth parents were similar. The findings presented in this paper strengthen the moral imperative to address the over-representation of care leavers amongst birth parents whose children are placed for adoption. There is an urgent need to revise how children and young people in state care are prepared for parenthood and supported as parents.     

The Parenting Task: Parent's Concerns and Where They Would Seek Help

ABSTRACT

Governments are concerned to promote positive parenting but it is difficult to know how and where to target the necessary support. How should we listen to the concerns expressed by parents themselves? Social work and health care professionals and those involved in developing parenting programmes tend to base their interventions on their experiences with families already in crisis. This paper reports on a survey of the views of two groups of parents: a community sample and a small group of parents involved in a young parent's project. Issues, which concern the parents, are identified as well as consideration of which agencies might be best placed to address these. Parents were most likely to approach their children's school or doctor for information, advice, or support. Parents were found to be reluctant to approach social work agencies.     

The experiences of youth serving as caregivers for mentally ill parents: a background review of the literature

Young caregivers of mentally ill parents are a vulnerable population. These vulnerabilities include risks for developmental issues, poor socialization, and poor school performance. The purpose of this background review of the literature is to explore the experiences of young caregivers of mentally ill parents and detect the gaps in the literature. The guiding research questions were: What is the experience of young caregivers of mentally ill parents? and What is the experience for those who witness or must assist their parent during a crisis? The majority of research has been conducted outside the United States, primarily in the United Kingdom, and studies have focused mostly on young caregivers of parents with physical rather than mental illness. No studies focused on young caregivers who witnessed or assisted their mentally ill parent in crisis. Information gained through this review will add to the body of knowledge for child mental health and build a case for additional research.     

An analysis of the relationship between parenting self-efficacy,the quality of parenting,and parental and child emotional health

ABSTRACT

The relationship between parenting self-efficacy, the quality of parenting, and parental and child emotional health has been conducted with Caucasian families and young children. The purpose of this study was to examine these relationships in ethnically diverse and impoverished families with children who have behavior problems. We examined the relationships between parenting self-efficacy, parenting practices, child externalizing problems, and caregiver depression. Participants included 213 caregivers of children with Oppositional Defiant Disorder (ODD), who rated their parenting self-efficacy and completed questionnaires on parenting practices (APQ and FAD); child externalizing behaviors (Iowa Connors Inattention and ODD subscales); and caregiver depression (CESD). Data were examined using Chi-Square tests, a Linear Regression, and a One-Way ANOVA. Results demonstrate parenting self-efficacy was positively associated with positive parenting and inversely associated with inconsistent discipline. Among parents who perceived themselves as being a “better than average parent,” there was a greater percentage of youth who met cutoff for inattention problems as compared to youth who did not meet this cutoff. Lastly, depression scores were lowest for caregivers identifying as below average parents. This study underscores the need for involving parents and enhancing parenting self-efficacy in interventions targeting Disruptive Behavior Disorders.     

Experiences of Biological Parents and Their Older Children in Out-of-Home Care for the First Time

This article will examine the parenting characteristics and challenges that faced a cohort of families participating in an exploratory qualitative research study. This study sought to describe the experiences and characteristics of parents whose children were placed in the child welfare system in early-to-late adolescence (ages 12–18), thus gaining an understanding of the parenting challenges faced as they were able to maintain their children in their homes for a significant portion of their lives. The families of older youths entering care for the first time described how alcohol and drug abuse impacted their relationships with children, significant others, jobs, and their mental health status. A significant issue that emerged in several of the cases were older children who initiated a report to child welfare themselves.     

Young Adult Carers: The Impact of Caring on Health and Education

Research has shown that young people who care for parents and relatives (young carers and young adult carers) are at greater risk of mental and emotional difficulties and are more likely to do badly at school or college. To explore the difficulties faced by young adult carers (aged 14–25) in the UK, an online survey was conducted. Almost half (45%) of the 295 respondents reported having a mental health problem. The relationship between the extent of caring and perceived mental health problems and the impact of caring responsibilities on work and education were investigated.     

Family Mediation: A Guide for Family Therapists

Family therapists often see separating parents who need to agree on co‐parenting arrangements. This article provides a guide to current research and practice in family mediation. The limited available research suggests mediation is a useful approach for some separated parents and their children, but often is not successful with highly conflicted parents, parents with mental health problems, parents struggling to accept the separation from their partner, or parents with unrealistic co‐parenting expectations. We analyse ways in which mediation might be enhanced, and discuss the potential roles of family therapists to support separating families to negotiate positive co‐parenting.     

The mental health of young people aging out of care and entering adulthood: Exploring the evidence from England and France

This paper explores the research evidence from England and France on the mental health of young people aging out of care and into adulthood. It represents the first comparative review based on the evidence from these two countries. Set in the legal, policy and service framework for both countries, it reviews evidence on the mental health of young people in the general population, young people living in care, young people aging out of care, and young adults. It shows: the high levels of psychological adversity of young people entering care; the high rates of mental health problems of young people in care compared with the general population of young people; the increased risk of mental and physical problems at the time of aging out of care, and the general improvement in longer-term outcomes for young adults, although some continue to have serious mental health problems. In conclusion, it suggests that interventions across the life course of young people are needed.     

Intersection of homelessness and mental health: A mixed methods study of young adults who accessed psychiatric emergency services

Young adults who experience homelessness have high rates of mental disorders, yet low rates of outpatient mental health service use. This mixed methods study examined the intersection of homelessness and mental health in a sample of 54 young adults (ages 18–25) who were hospitalized on a short-term, inpatient psychiatric unit. Nearly half (n = 26) reported being homeless in the prior year and more than a quarter were homeless at the time of admission (n = 15). Qualitative analyses identified key factors that contributed to both mental health problems and homelessness including disrupted support networks, fragile family relationships, foster care involvement, substance use and traumatic events. Homelessness was both a facilitator and a barrier to successfully accessing mental health services to manage mental health symptoms. Findings highlight the interconnection of homelessness and mental health and their common relationship with additional underlying risk factors. Providers across service settings need to recognize the overlap of client populations and provide integrated, trauma informed care to address housing instability, mental health, and substance use together.     

Factitious Illness by Proxy: Understanding Underlying Psychological Processes and Motivations

Children are put at risk of emotional and physical harm when parents seek unnecessary medical care. Understanding why parents seek medical interventions that create risk for their children requires us to consider how past experiences, and the mental representations of these experiences influence current behaviour. Past experiences of danger affect how parents interpret ‘dangerous’ situations in the present and how they organise protection of their child. This article demonstrates how the notion of mental representations (that dispose parents to act in particular ways) can assist in engaging, assessing and treating parents who display factitious illness by proxy behaviour. When classified using the Dynamic‐Maturational Method, the Adult Attachment Interview (AAI) allows both assessment of implicit and explicit representations and also understanding of the developmental process through which parents have learnt to attribute meaning to information and to organise their behaviour. In this case study, psychosocial assessment of the family included an AAI with each parent. The use of this assessment tool both aided the therapy team in the process of case formulation and intervention planning, and had therapeutic value in and of itself. We argue that treatment is more likely to be effective if the parents and professionals have a shared understanding of the parents' intentions and the developmental process that led to unsafe behaviour, which requires change.     

Primary care for young African American men

Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.     

Practice Wisdom on Custodial Parenting with Mental Illness: A Strengths View

ABSTRACT

Social work principles of strengths, empowerment, and consumer-centered care for persons with mental illness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mental illness, a potentially increasing group of consumers in light of mental health reform. The research team organized thirty-six professionals with practice experience into five focus groups. Findings reflect strengths perspective categories of resilience, social support, family functioning, self-care, and parents' positive experience of their symptoms. Implications discuss how providers who work with custodial parents and their children can apply these findings in assessments and interventions.     

Do Young Mothers and Fathers Differ in the Likelihood of Returning Home?

Building on research examining “boomerang” adult children, the author examines multigenerational living among young parents. Returning home likely differs between young mothers and fathers given variation in socioeconomic characteristics, health and risk taking, their own children's coresidence, and union stability. Using the National Longitudinal Survey of Youth 1997 (NLSY97), the author finds that more than 40% of young parents (n = 2,721) live with their own parents at their first child's birth or subsequently. Mothers are generally less likely to move home than fathers but only when not controlling for child coresidence and union stability. Individuals who live with all their children are less likely to return home, and controlling for child coresidence reverses gender differences, though this association disappears in the full model. Young parents who are stably single and those who experience dissolution are highly likely to return home compared to the stably partnered, with the association significantly stronger for fathers than mothers.     

The variation in family background amongst young homeless shelter users in Denmark

This article analyses variation in the family background of young homeless people in a cohort of young Danes. The study is based on administrative data for individuals who were 18 years old in 2007 and their parents. Homelessness is measured by shelter use over a five-year period. Data also cover education, employment, mental illness, substance abuse problems and placement outside home in childhood for the young persons, and education, employment, civil status, mental illness and substance abuse problems for their parents. A cluster analysis identifies two groups, each comprising half of the young shelter users. In the first group, social marginalisation is transmitted between generations, as most parents have low education and mental illness or substance abuse problems, and are unemployed. In contrast, the young people in the second group come from wider socioeconomic backgrounds, with few of their parents having mental illness or substance abuse problems. These young people develop psychosocial problems and become homeless without strong predictors from their family background. Amongst the young shelter users from families with severe social problems a higher share are in the Not in Education, Employment or Training group. They also have more shelter stays, compared to young shelter users from families with fewer social problems.     

Externalizing problems in young foster children: Prevalence rates,predictors and service use

Objective

Examining the prevalence of externalizing problems, their predictors and mental health service use for these problems by foster children and foster parents in a representative group of foster children aged 3 to 12 in Flanders.

Method

Survey data were collected on 212 foster children, who had been in the foster family for approximately four months. Foster parents filled out a Child Behavior Checklist to measure foster children's externalizing problems. Foster care workers reported on several potential risk variables for externalizing problems and on foster children's and foster parent's mental health service use. Predictors of externalizing problems were identified from a large number of variables using the method of purposeful selection of variables in linear regression.

Results

40.6% of the foster children had externalizing problems. Foster children who were placed because of behavioral problems had more externalizing problems. Only 20.9% of the foster children with externalizing problems and only 13.9% of their foster parents received professional help.

Conclusions

This study showed that externalizing problems are prevalent in this young foster care population, that it is hard to predict which foster children had externalizing problems, and that foster children and their foster parents rarely receive services for these problems. These findings call for a standard protocol of assessment of foster children's externalizing problems. Moreover, from a preventive viewpoint, guidelines are needed to systematically link young foster children with externalizing problems and their foster parents to appropriate services.     

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.     

Keeping Parents in the Driver's Seat

Parents receive social work services (both voluntary and involuntary) in a variety of settings. Although the parents may have come to need social work interventions for different reasons, one reason is constant: They are experiencing some difficulty with their children. Children are likely to benefit when parenting ability is strengthened. In all settings, social workers have a unique opportunity to assist parents in establishing, restoring, or maintaining healthy family dynamics.     

Age and gender differences in the well-being of midlife and aging parents with children with mental health or developmental problems: report of a national study

Using data from the Study of Midlife in the United States (MIDUS), this article examines: (1) the effect of having children with developmental or mental health problems on parents' mental and physical health, (2) the extent to which this effect varies by parental age and gender and (3) the effects of disability-related factors on the well-being of parents of children with disabilities. Compared to parents of non-disabled children, parents of disabled children experienced significantly higher levels of negative affect, marginally poorer psychological well-being, and significantly more somatic symptoms, controlling for sociodemographic variables. Mothers did not differ from fathers in their well-being. Older parents were significantly less likely to experience the negative effect of having a disabled child than younger parents, suggesting an age-related attenuation of the stress of non-normative parenting.