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Thursday, July 22, 2010

Legislation

The majority of child protection legislation in western societies focuses on family preservation. This reflects the moral foundation that the family is the best place to raise a child and the family is the foundational unit of the society. For the vast majority of children, this is a true statement. While most of us can look back on the family we grew up within from a critical perspective saying, "Oh, I wish mom or dad had done... or not done...", we still view our childhoods as essentially good experiences.
This is something that most clinicians need to remember as we spend much of our time with children and adults who have not had those experiences. We see people whose childhoods have typically been less than ideal. Those of us working in the realm of child protection tend to see people whose lives have been very negatively impacted by lives in families of origin.
Yet it is that very reality that legislation must also consider - those familes that are not safe and cannot be made safe. These families are the ones where addiction, abuse, domestic violence, substance abuse, chronic menatl health issues are the profound themes of life. Nurturance, attachment, care and attention are greatly diminished or absent.
Children in foster care often come from homes where these problems abound. Legislation rightly directs child protection authorities to try to change what is going on - to see what can be done to make the family at least good enough and thus, preserve the family unit. A noble goal that works in many cases.
Legislation typically considers those cases where change is not possible and raises ways for courts to consider termination of parental rights(TPR). One of the major challenges for child protection is when to give up on the family and seek solutions for children in foster care, kinship care or adoption.
Critics of TPR point to research such as that being done by Chapin Hill that shows that long term outcomes for children aging out from foster care don't od that well in social and economic terms. But then children growing up in these highly deficient families don't do that well either.
So what is the balance? This is a delicate question but those who criticize TPR and those with a more conservative view believe that family preservation is something of a holy grail and that you should almost never give up on the family unit except in the most extreme cases. Where is the line to be drawn?
This is the challeneg of child protection on a daily basis - case by case; child by child. Family preservation is important but should we be making valiant efforts? If the child has spent almost as much time if not more of their lives in foster care than with their biological family, what are we trying to preserve? If the parents have chronic problems that seem resistant to change such as frequent substance abuse relapses, what are we requiring the child to endure in order to preserve the family unit? If despite interventions, parenting capacity remains poor, can we accept that the parent just can't do the job? These are difficult questions. Legislation and the moral agenda of government and society sways the clinical decision making. Should it?

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