Treatment Approaches for Child Welfare Mothers with Addiction Problems

Abstract

This paper argues that child welfare mothers with addiction problems may require specialized treatment approaches based on their gender. The prevalence of women's problems with addiction and the unique ways addictions manifest themselves in women are discussed. The literature is then used to guide a discussion on the limitations of traditional treatment approaches that have been designed for men and may be of ill service to child welfare mothers. Alternative treatments are reviewed, and suggestions for improving treatment services to child welfare mothers with addiction problems are provided.     

The California Collaboration

Summary

This article documents the Title IV-E child welfare social work project of the California Social Work Education Center (CalS WEC): The establishment and ongoing support of collaborative arrangements among 58 California counties, the California State Department of Social Services, and all of the California graduate social work schools. The primary goal of this collaboration is to produce MS Ws who will commit to helping disadvantaged children and families in publicly supported child welfare services. The project model contains five interdependent components: a competency-based curriculum, financial support for students, development of instructional materials, active participation among public child welfare agencies and the universities, and evaluation.

This paper focuses on the collaborative curriculum development process. Evolving arrangements among stakeholders are described here in terms of the reciprocal adjustment of curriculum development and field and classroom instruction to prepare MSWs for public child welfare careers.     

An examination of attachment representations among child welfare professionals

Research has documented a relationship between adult attachment representations and client relationships and outcomes for professionals in relationship-based fields (e.g., , , , , ,  and ), but has not examined the child welfare professionals specifically. The current study examined attachment representations of 54 child welfare professionals. The Adult Attachment Interview (AAI) was administered to participants prior to attending a professional workshop. Results indicated significant differences between the AAI distribution of child welfare professionals and a non-clinical norm sample (AAI four-way distribution: Goodness of fit χ² = 23.63, p < .01; Bakermans-Kranenburg & van IJzendoorn, 2009). Dismissing classifications were overrepresented and free-autonomous classifications were underrepresented. Results may indicate challenges in the child welfare system that could alter the effectiveness and decision-making processes of child welfare professionals. Further research is needed to evaluate whether these differences are typical for samples of child welfare professionals and if so, the impact it could have on families who are being served. Effective interventions, focused on shifting attachment from insecure to secure, for child welfare professionals also should be explored through further research.     

Toward a Competent Child Welfare Service Delivery System for Gay and Lesbian Adolescents and Their Families

SUMMARY

Analogous to the child welfare delivery system deficits that have been documented for people of color communities, the problems encountered by gay and lesbian adolescents and their families are frequently ignored and largely unrecognized by the majority of child welfare professionals. An understanding of the impact of societal stigmatization of gay and lesbian individuals and their families is crucial to the recognition of, and response to, the needs of this population. This paper posits that the development of competence in this area holds promise for preserving and supporting families and for the establishment of appropriate gay/lesbian-affirming child welfare services for these young people and their families.     

Kinship Care and Public Child Welfare: Challenges and Opportunities for Social Work Education

Abstract

The growing practice of arranging and financing “foster placement” of abused and neglected children with relatives provides an opportunity to redefine relationships between extended families and the child welfare system. The dilemmas and possibilities presented by kinship care as a child welfare service challenge schools of social work to provide intellectual leadership and to prepare social workers for changing child welfare practice. The author's ideas concerning responses to this challenge focus on key mandates of the Council on Social Work Education's Curriculum Policy Statement and on five principal curriculum areas in social work education.     

Challenging implicit bias: preparing students to practice with African American families

ABSTRACT

The disparity of African American families in the foster care system is a concern in the field of child welfare services and the social work profession. African American families experience unique challenges related to discriminatory practices and implicit biases in the child welfare system and by mandated reporters. To address these inequalities, state and local agencies have implemented prevention and intervention services to support minority families. Additionally, child welfare agencies have invested in professional development training for their workers to alleviate possible intolerant practices. This article describes implicit biases and considers how they could contribute to the disparity of African American families involved in the child welfare system. Furthermore, the article presents approaches to help social work students to identify and challenge their implicit biases to support culturally sensitive practices while working with African American families. It concludes with implications for social work education.     

Trends in infants reported to child welfare with neonatal abstinence syndrome (NAS)

BackgroundSubstance abuse among caregivers is a known risk factor for child maltreatment, and some of these children subsequently come to the attention of the child welfare system. The recent opioid epidemic has led to rising numbers of women who use opioids during pregnancy and infants born with neonatal abstinence syndrome (NAS), raising the question of whether there has been a consequent rise in the numbers of these infants reported to the child welfare system. The purpose of this study is to examine the trend in the number and percentage of infants reported to the child welfare system with neonatal abstinence syndrome (NAS) from 2004 to 2014, and determine whether the trend is distinct from the trend in the percentage of infants reported with fetal alcohol spectrum disorder (FASD).MethodsWe analyzed National Child Abuse & Neglect Data System (NCANDS) data on reports of infants (aged <1 year) with NAS between 2004 and 2014. Due to state differences in data collection and data quality across the study period, the sample included reports from 10 states. We utilized a Generalized Estimating Equations (GEE) model approach to examine the trend over time in the percentage of NAS and FASD cases reported to child welfare in our 10 state sample. Year was used as an identifying variable and Substance Type was repeated over time and clustered by State.ResultsThe number of reports of infants with NAS for the 10 states was the lowest at 3073 in 2009 and highest at 4806 in 2014. The average percentage of cases of NAS reported rose from 4.72% in 2004 to 9.19% in 2014. The results of the GEE revealed a significant main effect of Substance Type (p = 0.015) and Year (p = 0.009), indicating that overall, averaged across time, the percentage of NAS reports was greater than the percentage of FASD reports and averaged across substance type, the percentage of substance-related reports increased over time.DiscussionNAS reports increased significantly over time, most pronounced between 2010 and 2014, while the trend for FASD reports did not show significant change over the study period. Moreover, the child welfare reports data obtained from the 10 state sample aligned with national NAS incidence data. Although recent efforts to curb prescribing and other means of supply have been implemented, it remains to be seen whether the large rise seen will continue or be ameliorated by these public health initiatives. However, overall these findings suggest that immediate efforts are needed to prepare the child welfare system for this trend, as well as to treat opioid addiction among women of child bearing age.     

Examining risk,strengths, and functioning of foster families: Implications for strengths-based practice

ABSTRACT

Foster families provide safe and stable homes for children and youth who are removed from their homes due to maltreatment. Despite the stressors associated with bringing children in and out of a family’s home, many maintain healthy family functioning and continue fostering for many years serving an essential function in the child welfare system. This study sought to understand the factors that explained higher levels of family functioning within foster families. Collaborating with one statewide public child welfare agency, 681 licensed foster parents participated in an online survey that examined the association between family functioning with family strengths and risk factors. Findings from this study can inform strengths-based practice including training, assessment, and interventions for new and existing foster families to strengthen families and improve the well-being of children and youth in their care.     

The role of interagency collaboration for substance-abusing families involved with child welfare

Meeting the needs of families involved with the child welfare system because of a substance abuse issue remains a challenge for child welfare practitioners. In order to improve services to these families, there has been an increasing focus on improving collaboration between child welfare, treatment providers, and the court systems. This paper presents the results from qualitative interviews with 104 representatives of these three systems that explore how the collaborative process works to benefit families, as well as the barriers and supports for building successful collaborations. Results indicate that collaboration has at least three major functions: building shared value systems, improving communication, and providing a "team" of support. Each of these leads to different kinds of benefits for families as well as providers and has different implications for building successful collaborative interventions. Despite these putative benefits, providers within each system, however, continue to struggle to build effective collaborations, and they face such issues as deeply ingrained mistrust and continued lack of understanding of other systems' values, goals, and perspectives. Challenges that remain for successful collaborations are discussed.     

Welfare Status and Child Care as Obstacles to Full-Time Work for Low-Income Mothers

SUMMARY

In this study, we use new data from the Philadelphia Survey of Child Care and Work to expand on previous analyses: we include child care problems as a work obstacle, and we analyze both current welfare recipients and non-welfare “working poor” mothers. Results show that two main obstacles have a large impact on full-time work: poor mental health and child care problems. Net of other factors, mothers with severe child care problems are 22 percent less likely to work full time. Dividing the sample by welfare status, we find a child care problems effect for both groups. Among welfare recipients, the gap in full-time work between those with severe child care problems and those without is 30 percent. Among the working poor, child care problems reduce the chance of full-time work by about 18 percent. Our findings show that improving mothers' child care situation can significantly improve their ability to support their families.     

Serving families with child maltreatment and substance use disorders: A decade of learning

ABSTRACT

An increase in parental substance use disorders (SUD) and the number of infants and toddlers entering foster care has prompted federal and state efforts to change the treatment paradigm toward more integrated and family-centered strategies. The Regional Partnership Grant (RPG) program demonstrated that family-centered strategies can improve child and parent outcomes. The current challenge is to bring effective strategies to scale. This conceptual article highlights the lessons learned from 10 years of implementing and evaluating programs to meet the needs of families affected by parental SUD and child maltreatment. Effective family-centered strategies identified by the RPG program are illustrated with specifics from the Sobriety Treatment and Recovery Team program. These effective strategies could be implemented in any jurisdiction and include (1) collaboration toward integrated services between child welfare and SUD treatment, (2) timely access to SUDS treatment, (3) recovery management and support, (4) tailored family services, and (5) adaptation to local jurisdiction needs. When these strategies are operational, children are more likely to be safe and remain in parent custody, and parents are more likely to achieve sobriety and improve their parental capacity. Future research might examine the unique impact of each of the five strategies independently.     

Challenges of Interdisciplinary Collaboration

Abstract

The realities of the 1990s, which include reduced funding and resources, the public's impatience with bureaucratic rigidity, and the empowerment of families who want timely and appropriate services, have created a favorable climate for collaborative, interdisciplinary practice. Collaborative, family-centered practice models are being promoted by family/child advocates and professionals. Yet child and family services, for the most part, continue to be provided in traditional ways using individual treatment and categorical services. However, federal child mental health funding is supporting community-wide, collaborative practice in twenty-one sites scattered across the United States. One site, in rural northeastern North Carolina, is unique as it includes a graduate-level, interdisciplinary academic component [East Carolina University's (ECU) Social Sciences Training Consortium (SSTC)] to train and support service providers and families, and to prepare master's level graduates to work in such innovative programs. Called PEN-PAL [an acronym for Pitt-Edgecombe-Nash (three NC counties) Public Academic Liaison] this university/interagency collaborative effort works in partnership with families to coordinate public and community services into a seamless system of care for children with severe emotional disturbances. This article is based upon a qualitative study of SSTC faculty members, and it chronicles the successes and difficulties encountered by faculty in the first year of a five-year collaborative process.     

The Development of Adoption Law

Abstract

Adoption law in the United States, since its inception in 1851, has reflected changes in society and in child welfare practices. The author reviews its evolution from an issue involving property and inheritance, to a means of helping children and creating the ideal nuclear family, to the current understanding that virtually all children needing permanent homes are “adoptable” and that families can take many forms. She also recounts changes in the perceived “best interests” of all members of the adoption triad over time, and the growing recognition of links between adoption and child welfare policy. Finally, she discusses current controversies including open adoption; rights of birth parents, including unmarried fathers, and the role of culture and race.     

Silver Bullets and Quick Fixes

Abstract

Important lessons in policy implementation are available to welfare reformers who closely examine the case of the child welfare sys tem. Similarities exist between the Personal Responsibility and Work Op portunity Act of 1996 and the Adoption Assistance and Child Welfare Act of 1980. While substantively the two pieces are very different, current wel fare reform efforts are likely to repeat mistakes made by those implement ing child welfare system reforms in the 1980s and 1990s. Four factors threaten the success of reforms: The vagueness of language; the search for one single solution for all families; insistence on defining the complexity of family problems in extremely narrow terms; and the excessive bureaucrati- zation of service delivery. Policymakers are cautioned to look toward re cent innovations in child welfare for guidance instead of inadvertently repeating missteps.     

Facing Time Limits

Abstract

With reauthorization of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the horizon, policy makers need to have a sound understanding of the act's consequences for children and families. In contrast to earlier studies, the present study quantifies the impact of a 24-month state imposed welfare time limit on foster care placements. It also examines the impact of a “hardship” provision that temporarily excuses select families from meeting a two-year time limit on foster care placements in Nevada. In order to determine how these factors, in conjunction with other relevant welfare experiences and personal factors, affect parent-child separation, a multivariate logit model was tested. Key findings reveal that families who have more months counted toward their time limits also are more likely to have at least one child removed and placed in foster care. On the other hand, hardship families are not more likely to have their children placed in foster care than non-hardship families. The findings lend support to the notion of providing family-centered casework services to those identified to be at risk of approaching their welfare time limits. The findings also lend support to inter-agency collaboration between TANF and child welfare systems.     

Kinship Care: Analysis of the Health and Well-Being of Grandfathers Raising Grandchildren Using the Grandparent Assessment Tool and the Medical Outcomes Trust SF-36 TM Health Survey

ABSTRACT

As more and more children are being separated from their biological parents because of AIDS, substance abuse, mental and physical illness, incarceration, and child abuse and neglect, child welfare agencies are relying more often on kinship care as a viable option for out-of-home placements. In many cases, kinship care falls on the grandparents. While keeping children within their families is generally viewed as preferable by child welfare agencies, it can be a burden on grandparent caregivers, who often exist on severely limited incomes and without much assistance or support from social service agencies. A research project was conducted which used both quantitative and qualitative data from research conducted by Jones and Gibbons (2000) on grandparent care, but this study focuses on the experiences of grandfathers who participated in the project and examines their outcomes in several different areas.     

The Perceptions of Welfare Reform by Michigan Families Whose Children Have Disabilities and Welfare Caseworkers

Abstract

This article examines family and caseworker perceptions of welfare reform and services as they relate to families who have a child with a disability. Interviews were conducted with 39 families and 77 caseworkers. Family questions addressed their perceptions of the welfare system, factors impacting their self-sufficiency, and their perceptions of needed program changes. Caseworker questions addressed their perceptions of welfare practices and policies and their education needs related to serving families who have children with disabilities. Familial perceptions of the welfare system were validated by caseworker reports. Implications for service improvement are discussed.     

Mental Health Consumer and Carer Participation in Professional Education: ‘Getting There Together’ for Children of Parents with Mental Illness and Their Families

Abstract

‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘… the whole family, and how the child fits into the picture’.     

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.