Transcript The Child Protection System: - Home

The Child Protection System:
The Role of Family Preservation, Support, &
Kinship Care
Zoe Breen Wood
Case Western Reserve University
[email protected]
Amasaganalu
Introductions
• Name
• Agency / position
• A positive trait that you learned or developed
from your family
Goals for Today
• An Overview of a child protective system
– Key principles and beliefs
– Theoretical underpinnings
• Focus on initial components of a child
protection system
– Identification of Children at Risk
– Family Preservation
– Kinship Care
Building A Learning Community
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Start & end on time
Ask questions
Share expertise
Safe environment
Others?
Case Study: The Bahailu Family
• What are the family’s strengths?
• What are the family’s needs?
• What more do you want to know about the
family?
Foundations for our discussion
• Systems theory
• Ecological perspective
• Strengths base
• Maslow’s Hierarchy of
Needs
• Developmental
perspective
Systems Theory
• Whole / parts
• Movement in one
impacts movement in
others / all.
• Boundaries
• Multifinality
• Equifinality
Ecological Perspective
• Person-in-environment
Strengths Base
• All individuals, families
and systems have
strengths.
• Most effective
interventions identify
and build upon those
strengths.
Maslow’s Theory
“We each have a hierarchy of needs that ranges
from "lower" to "higher." As lower needs are
fulfilled there is a tendency for other, higher
needs to emerge.”
Daniels, 2004
Maslow’s Theory
Maslow’s theory maintains that a person does
not feel a higher need until the needs of the
current level have been satisfied. Maslow's
basic needs are as follows:
Basic Human Needs
• Food
• Air
• Water
• Clothing
• Sex
Physiological Needs
Safety and Security
Safety Needs
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Protection
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Stability
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Pain Avoidance
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Routine/Order
Love and Belonging
Social Needs
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Attachment
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Affection
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Acceptance
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Inclusion
Esteem
Esteem Needs
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Self-Respect
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Self-Esteem
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Respected by Others
Developmental Perspective
• Types of Development
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Physical
Cognitive
Psychological
Social
Emotional
• Stages of Development
The Child Protection System
• Goals
• Beliefs
• Model
Goals
• Safety
• Permanency
• Wellbeing
COMMUNITY
FAMILY
THE CHILD PROTECTION SYSTEM
Prevention
Institutional
Care
Identification
of Children at Risk
Child
Family
Preservation
Intercountry
Adoption
Reunification
Domestic Adoption
Kinship Care
Foster Care
GOVERNMENT AGENCIES
Independent Living
NGO’s
Guiding Principles
• Every child has the right to be protected.
(Convention on the Rights of the Child)
• Children do better in families.
• Children should be in the least restrictive
most home-like environment , as close to the
child’s own home as possible in which they
can be safe.
• The child welfare system must promote
permanence for all children
Guiding Principles
• Children have a right to remain connected to
their family, their community, their culture &
their heritage.
• Solutions to the challenges facing children are
best developed within the community with
assistance from those outside.
• The child welfare system must be culturally
competent.
• People can and do change.
• Change happens in the context of relationships
DISCUSSION
• Think about the Child Protection Model and
Your Agency / Program
– Where does your program fit?;
– What level of Maslow’s needs do you meet?
Today’s Focus
• Identification of Vulnerable Children
• Family Preservation & Support
• Kinship Care
• Tools for Assessment
COMMUNITY
FAMILY
THE CHILD PROTECTION SYSTEM
Prevention
Institutional
Care
Identification
of Children at
Risk
Child
Family
Preservation
Intercountry
Adoption
Reunification
Domestic Adoption
Kinship Care
Foster Care
GOVERNMENT AGENCIES
Independent Living
NGO’s
Risks to Orphaned, Abandoned and
Homeless Children
• Health
• Educational failure/lack of achievement
• Mental Health & Substance Abuse
• Incarceration/Criminal Involvement
Health
• Miller and Hendrie (2000) evaluated 452 children (443 girls) adopted
from Chinese institutions.
• The duration of orphanage confinement was inversely proportional to
the linear height lag (r = .9), with a loss of 1 month of height age for
every 2.86 months in the orphanage. Seventy five percent of the
children had a significant developmental delay in at least
1 domain: gross motor in 55%, fine motor in 49%, cognitive in 32%,
language in 43%, social-emotional in 28%, activities of daily living in
30%, and global delays in 44%.
• Overall, elevated lead levels were found in 14%, anemia in 35%,
abnormal thyroid function tests in 10%, hepatitis B surface antigen in
6%, hepatitis B surface antibody in 22%, intestinal parasites (usually
Giardia) in 9%, and positive skin test results for tuberculosis in 3.5%.
PEDIATRICS Vol. 105 No. 6 June 2000, p. e76
Educational Failure
• Case, Paxson, & Ableidinger in 2004 compared
educational outcomes for children in 10
Subsahara (African) countries and found
children orphaned due to HIV/AIDS are less
likely to be enrolled than are nonorphans with
whom they live, even when controlling for
poverty.
Demography, 2004; 41(3):483-508.
Mental Health
• Papageorgiou, Frangou-Garunovic, Iordanidou, Yule, Smith, &
Vostanis (2000) in a sample of 95 children of 8-13 years, who
had experienced war in Bosnia, were assessed with a battery of
standardised measures. They children either came from
refugee families (44%), meaning they had experienced
homelessness, or had suffered significant family loss (a parent
had been killed in 28% and the father was injured or absent in
27% of cases). Forty five children (47%) scored within the
clinical range of the depression, 28 (23%) on anxiety, and 65
(28%) on a scale measuring PTSD reactions.
• Imagine the mental health consequences for children without a family.
European Child and Adolescent Psychiatry, 9(2):84-90.
Incarceration/Criminal Involvement
• Huang, Barreda, Mendoza, Guzman and Gilbert in
2004 compared abandoned street children and
formerly abandoned street children in La Paz, Bolivia
• Some findings:
– higher risk of police abuse (95% versus 38%)
– Higher engagement in robbery (26% versus 4%)
Archives of Disease in Childhood 2004;89:821-826
Social Service Response
• Must be collaborative
– Medical Community and social services
– NGO and public/government services
– Faith-based community and secular community
Social Service Response
• There must a continuum of services, focusing
on permanency, safety & well-being
• The continuum must be community and
family based
• It must incorporate our knowledge of child
development as well as family and community
development
A Permanency Priority: Strengthen &
Preserve Families
• Unless there is compelling evidence
otherwise, initial efforts must focus on
strengthening and preserving families
– Abandonment Prevention for infants
– Abandonment Prevention for children on the
streets (children with families, children connected
to families and children on their own)
Strengthen & Preserve Families
• Requires workers who can assess, intervene and
advocate on behalf of vulnerable and at-risk families
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A systemic and ecological framework
Focus on strengths as well as problems and deficits
Case management
Crisis intervention
Immediate and long-term response
• Any solution or intervention has to take account the
historical and cultural context of the family being
served
Identification of Children at Risk
• Requires community standards about the level
of need which triggers a need for intervention.
• Determined by communities taking into
consideration culture and resources.
• What level(s) of Maslow’s hierarchy must be
met in order for children to be free of risk?
Discussion
• What are the legal definitions? Are legal
definitions needed?
• What mechanisms/ systems are in place to
identify children at risk?
• Do some components of your system focus more
on some categories to the exclusion of others?
• How well do the identification systems work
together?
• Are there gaps ?
Family Preservation
• Intervention and supportive services provided
to allow the child to remain with his family.
• These services can address: basic needs,
development, mental health, abuse/neglect,
trauma, violence, and natural disasters.
Family Preservation
• target population includes families who are at
imminent risk of having a child placed outside
the home or have been the subject of an
indicated maltreatment report
• in-home service provision
Family Preservation
• Crisis oriented and/or long term
• Case Management
• Empowerment & strength based
Examples of Family Preservation
Programs
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Emergency referrals
Food & economic support
Job training
Prenatal care
Home visits for mothers & young children
Health & developmental assessment
Parenting classes
After school & youth development programs
Discussion
• What family preservation programs currently
exist in your community?
• What level of Maslow’s hierarchy do they
address?
• How well do these programs coordinate their
services / collaborate?
• What are the gaps?
• What additional services need to be
developed?
Examples of Family Preservation
Programs
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Counseling
Child care
Mentoring
Support groups
Family activities
Life skills
Personal safety, and community awareness
Kinship Care
• Is family preservation and is a very good
permanency option
• Involves identifying appropriate family
members or fictive kin
• Assessing their willingness and ability to
provide safety, permanency & well being to a
child.
• Providing ongoing support.
Evaluation
Implementing
Planning
Assessment
Joining
Joining
Professional conversations and
personal conversations:
What are the differences?
Personal conversations
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Often spontaneous
Unstructured or semistructured
Subject to interruptions
Can be terminated abruptly
Do not need to reach resolution
Can tolerate a range of informalities – humour, touching,
provocation, challenge, ignoring etc.
Are influenced by diversity – age, language, class,
culture, ethnicity, politics, religion
Often are not strictly time limited
Can often be overheard by others
Are much influenced by the nature and history of the the
relationship – power differentials, empathy/conflict etc
Professional conversations
• More formal/constrained in language and style
• Generally not accompanied by physical contact
often structured or semi-structured
• Time limited
• Goal directed
• Power differentials play a major role
• Agency influenced
• Context dependent
• Voluntary or involuntary
Interview VS Conversation
• Interaction designed to achieve a selected purpose & content
is chosen to facilitate achievement of that purpose
• One person takes responsibility for directing interaction and
relationship is nonreciprocal
• Actions are planned, deliberate, consciously selected;
Interview requires attention to the interaction, is formally
arranged, & unpleasant feelings & facts are not avoided
• Concern with interface between clients and their social
environment
Working together toward goals
Creating a rapport and establishing a
relationship
• A harmonious working relationship (Barker, 1995)
• Rapport means “close and sympathetic”
• Social workers place great value on the quality of the
helping relationship (Coulshed, 1991)
• “The relationship is the communication bridge
between people”(Kadushin,1990)
• Feminists have seen building relationships as central
to empowerment and growth (Stone, 1991)
Cited in Trevithick (2000)
Features of an effective helping
relationship
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Concern for service user’s self-determination
Displaying interest, warmth and trust
Respect for individuality
Acceptance
Empathic understanding
Genuineness and authenticity
Establishing ground rules regarding confidentiality
Adapted from Kadushin (1990)
Discussion
• Identify things that interfere with a worker’s
ability to join with his or her clients.
• Identify strategies that help to join with the
individuals & families with whom you work.
Assessment
Assessment
• Is the process of gathering information that will
support service planning and decision making
regarding the safety, permanence and well-being of
children and families.
• Assessments are based on the assumption that for
service to be relevant and effective, workers must
systematically gather information and continuously
evaluate the needs of children and families as well as
the ability of family members to use their strengths
to address their problems.
Assessment is…..
• Gathering information and formulating a coherent
picture (hypothesis) of the client, their environment
and their circumstances
• The beginning of the working relationship
• The basis for the rest of our work with the client:
goals, interventions and progress
• Constant
• ALWAYS includes: 1) problems or concerns as seen
by the client, 2) legal mandates, & 3) safety concerns
Assessment is a process
• Begins immediately when your client walks through the
door
• Changes from moment to moment
• Is based on both your and your client’s views
• Influenced by your interviewing skills
• Involves the process of gathering information from client,
reading documents, observing client, engaging collateral
sources of information…
• Is accomplished through EXPLORING
Assessment is a product
(e.g., A Written Document)
• Provides guidelines for organizing information
• Includes assessment of the problem, person and
environment
• Problem assessment is not always as easy as it seems
– New problems emerge as work continues
– Underlying issues not showing on the surface (e.g., Truancy)
• Written in a clear, concise & relevant manner
• Is strengths-based
• Ongoing tool for work together
In the Child Welfare System
Assessment
• Cornerstone of family-centered child welfare practice
• Can be very simple, can be very complex
• Must be based on thorough, accurate, relevant and
current information
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Assessment of
Child Maltreatment
 Psycho-Social Factors
 Child Characteristics
 Environmental Factors
 Family Characteristics
 Parental Conditions that Impair Parenting
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What do you see?
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List all the items
you observed
in the previous slide
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Information Processing
• What do we notice?
• What happens right in front of us that
we don’t notice?
• What leads us to notice some things
over others?
• What barriers that prevent us from
noticing what matters most?
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Salience depends on:
Strength
Repetition
Strangeness
Movement and change
Emotional reaction
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So what’s the point?
Our assessments are ineffective if we:
• Draw conclusions with insufficient or
erroneous information
• Do not have relevant information
• Speed up the process
• Don’t know the area being assessed
• Draw conclusions from only part of the
information and allow . . .
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Personal Factors that Cloud Assessments:
• Cultural aspects of the worker or
family
• Bias of previous information
• Confirmation bias
• Limited available information
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Personal Factors that Cloud Assessments:
• Emotional condition of the
assessor
• Personal involvement in the
situation
• Environmental conditions
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Types of Assessment
• Safety
• Risk
• Family
Safety Assessment
• Imminent threats to safety
• “if I walk out of here right now without
intervention, will the child be safe?”
Best Practice in Safety Assessment
• Use open ended questions to build rapport.
• Talk to them at their level, from their starting place
(cognitively and emotionally)
• Interview the child in a neutral place
• Talk to everyone in the family as well as others who
may have knowledge of the condition
• Talk to the parents of caregivers
• Ask consistent questions
• Get an understanding of the family’s perception of
the current situation
Risk Assessment
• Future focused
• Risk factors
• Protective factors
• Leads to a hypothesis of the likelihood of
future harm.
Comprehensive Family Assessment
• The following are characteristics or problem areas
most commonly associated with families in the
child welfare system:
• Problems in accepting responsibility, in the
ability to recognize problems, or in motivation to
change;
• Patterns of social interaction, including
aggressiveness or passivity,
• the nature of contact and involvement with
others, the presence or absence of social support
networks and relationships;
Categories of Parental Assessment
• Parenting practices (methods of discipline,
patterns of supervision, understanding of child
development and/or of emotional needs of
children);
• Background and history of the parents or
caregivers, including the history of abuse and
neglect;
• Problems in access to basic necessities such as
income, employment, adequate housing, child
care, transportation, and needed services and
supports; and
Categories of Parental Assessment
• Behavior/conditions associated with
o Domestic violence
o Mental illness
o Physical health
o Physical, intellectual, and cognitive
disabilities
o Alcohol and drug use.
Elements of Child and Youth
Assessment
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Physical health and motor skills
Intellectual ability and cognitive functioning
Academic achievement
Emotional and social functioning
Vulnerability/ability to communicate or protect
themselves
• Developmental needs
• Readiness of youth to move toward
independence
Elements of Child and Youth
Assessment
• Readiness to live interdependently
• Ability to care for one’s own physical and mental
health needs
• Self-advocacy skills
• Future plans for academic achievement
• Life skills achievement
• Employment /career development
• Quality of personal and community connections
Elements of Family Assessment
• Social network
• Relationships among family members
Elements of Environmental
Assessment
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Adequacy and safety of housing
Access to services
Presence / absence of health hazards
Exposure to violence
Assessment Tools
• Genogram
• Ecomap
Definition
• GENOGRAM = GENETIC MAP
• Also known as family tree but has additional
features.
• It visualizes hereditary patterns and
psychological factors that punctuate
relationships. It can be used to identify
repetitive patterns of behavior and to
recognize hereditary tendencies.
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Drawing the Genogram
The basic skeleton of a genogram
Basic Symbols
Symbols: Marital and other
Relationships
Symbols of Multiple Marriages
Generational Relationships
A more complex skeleton
Identifying information
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Names
Nicknames
Birth date
Marriage dates
Divorce dates
Separation dates
Sibling position (birth
order—include siblings
who died)
• Family comparisons
• Personal
characteristics or
characterizations
• Occupations and job
histories
• Illnesses
• Hobbies and other
interests
• Death date (if
appropriate) and
cause of death
Three-Generation Genogram
Name:
Date:
Grandparents
Great Aunts and Uncles
Parents
Aunts and Uncles
Patient
Siblings and Spouse(s)
Children
lump
Develop A Genogram
• Your own family
• OR
• One of your client’s families
Discussion
• What can you learn from a genogram?
• How can you use this tool in your work?
Ecomap: What is it?
A paper-and-pencil assessment tool
The ecomap is a “snapshot” of the client within
their family and social environment at a
particular point in time.
Used to assess specific needs and plan
interventions for a client.
• An Eco-map is a graphical representation that
shows all of the systems at play in an
individual's life.
• They can also be used to depict the flow of
“energy” into and out of a system.
• Eco-maps are used in individual and family
counseling within the helping professions.
Interaction With the Environment
Systems theory and/or ecological perspective
view of the client’s family life.
Reveals the nature of the family’s relationships
with the outside environment.
Social Environment
Basic Ecomap Symbols
Female
Male
Connections to the Environment
• Connect the environment outside of the
family with the family members.
• Where is energy being directed and what
is the nature of that exchange?
• What is the quality of that exchange?
Interaction With Social Environment
Identified Client
Commonly Used Symbols
Stressful, conflictual
relationship
+++++++
Tenuous and/or
uncertain relationship
Positive relationship
or resource
The direction of the
giving & receiving
exchange or a relationship
or resource
(also known as energy)
------_________
Draw an Ecomap
• Your own family
• A client family
Discussion
• What can you learn from an ecomap?
• How can you use this tool in your work?
Strengthen communities to promote
permanency and child well-being
• Families can only be a strong as the communities in which
they live
– We need to understand community values, needs and problems
– We need to raise community consciousness about the problems being
experience by their families
• We need community workers who can promote social and
economic development for vulnerable and at-risk
communities
– Micro-enterprise & job development
– Neighborhood and housing development
• Any solution or intervention has to take account the historical
and cultural context of the community being served
Move away for linear planning models
Move towards concurrent planning for children
rather than linear models of planning for
children
The Social Service Response
• Needs to be both reactive and pro-active
• It is about programs but also about social
policy
• It is about services but it is also about
advocacy
Application to Practice