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Monday, November 29, 2010

Another high profile death awaits

At the risk of sounding alarmist, the risk of yet another high profile death of a child known to child protection authorities is just around the corner. How can I feel so secure in saying this?

News media are beginning to report the worrying trend of major cutbacks in funding. These inevitably lead to layoffs and the reduction of resources. Fewer child protection workers struggling with systems where there are fewer supports to offer families. This leads to the choice of apprehending a child where supports may have kept a child in the family or, in the alternative, simply determining that only the most serious cases will have files opened (and thus the hope that the child will make it through).

There are those, such as the NCCPR who say that only focusing on real cases of neglect or abuse may be a good thing. They might argue that too many cases are being opened and far too many children apprehended - put the resources against sustaining families and apprehend fewer children. They might suggest that is cheaper and better for society. One doubts that NCCPR spends much time at the front line trying to make the apprehension decision. But, they have a point that resources need to be used wisely and cases opened that really need intervention. If only we, as a society, could agree on that and avoid forcing social workers to make those decisions knowing that limited resources are available.

As Wotherspoon et al., note in a recent article on presenting infant mental health concerns to the courts, many of the interventions that we are using with families are not necessarily effective. Not enough evidence based resources are generally available that recognize the intense and long term supports that many families need. It is not enough to be critical of the apprehensions if you are also not willing to support the funds needed to actually make a difference in families while trying to keep the children with their parents.

Three articles in the last few days tell us that resources are getting tighter. An Australian writer today notes the problems of burnout in CPS workers ( reports today, "All of Derbyshire Council's social care workers have been given the opportunity to apply for voluntary redundancy or early retirement in an attempt to save £84m following government spending cuts"

Another report from another area of the UK notes "Around 300 children's services posts are at risk in Cumbria as the county council braces itself for a raft of cuts to government grants."

These cuts in the UK will affect a broad range of social workers and supports to families. Will the public stand in support of child protection when the next high profile death occurs looking to the politicians and say it was their responsibility because they cut so many resources? One doubts it!


The Representative for Children and Youth in British Columbia today issued a report on the progress from the Hughes Commission of Inquiry. It is not flattering but it also emphasizes how the economy adds to the challenges of child protection. The commissioner states, "Difficult economic times can mean harsher realities for many of B.C.’s families. Poverty will deepen for some, unemployment rates may climb, and previously successful families may struggle. Social services may be required more often, and community supports may disappear. Stagnant or decreasing budgets will not be able to address the needs of additional children and families" (p. 17).

The adage of doing more with less comes to mind - the recipe for one of those high profile deaths.

The full B.C. report can be found at

Tuesday, November 16, 2010

Crisis in child portection

An Australian professor writing in the Sydney Morning Herald yesterday has again highlighted problems that are facing child protection there but the themes are familiar ones throughout the western world:

* under staffing
* need for more education and training
* weak management
* failure to recognize the workers
* high caseloads

These themes are seen in Canada, the UK, USA, New Zealand and elsewhere. Yet, government seems helpless to solve the problems. This may be a function of the child protection model but we may also have to ask some very challenging questions. Are we simply trying to protect too broad a range of problems and families with resources that we are not prepared to fund? In other words, are we simply saying that we have broadened the definition of who should be protected far beyond what we are willing to pay to address? Therefore, has the burden of the child protection system been expanded so far that success is virtually impossible in a broad way?

The ongoing saga of inquiries into the child protection systems suggests so. A redefinition of who needs protection is required but there is nary a politician who may be up to the task. Who, after all, wants to say that we should stop protection for families because we are going to narrow the definition of who is deemed bad enough for services?

Yet, by expanding the definitions of who should get intervention beyond what we can afford to support, we are saying that we will generally do a poor job across large portions of the caseloads. There are only so many cases that any worker can do well.

The social work profession should be leading this debate. With the many political mine fields that come with it, however, is it any wonder that there are few voices who suggest anything other than fewer cases per worker, hiring more workers (an increasingly scarce resource) and increasing funding (with government finances also an increasingly scarce resource).

These are just a few of the very difficult questions that need asking. It will be interesting to see what the Munro commission in the UK ultimately comes up with. Prof. Munro is in the challenging position of trying to suggest a direction for a child protection system that has been under siege in that country for years.

There is a need to challenge the very basic underpinnings of our present child protection systems. It will take a very brave leader indeed to do that.

The Australian article can be found at

Sunday, November 14, 2010


I have counseled children who have been adopted, their parents as well as biological parents who have lost their children.

Often, I am struck by what adoptive parents are not told. They are expected to take on the responsibility for raising a child who has frequently suffered in pre-adoption periods either through unhealthy pregnancies, attachment problems, neglect and abuse - or all of the above. Somehow, we expect adoptive parents to take on these children with one hand tied behind their backs as they only get to learn about what happened to the child as behaviors emerge.

I have regrettably even had cases where the truth about how bad it was for the child pre-adoption was not only withheld but downright misrepresented. In a letter to the editor of The Guardian newspaper in the UK, a magistrate has very nicely summed up the problem with this approach. She writes:

"You write in your editorial that parents who adopt "must be offered support" and that "children who are removed from dysfunctional homes need support for longer than is currently provided". I would like to suggest that using the term "support" in this context is to underplay the serious psychological damage which is the consequence of the "extreme abuse or neglect" suffered by 71% of those adopted, to quote again from your editorial. Where there is psychological damage, it is not support which is required, but serious therapeutic assessment and intervention of the sort offered by trained child psychotherapists.

We should not expect adoptive parents to provide psychotherapeutic treatment for traumatised children. We should be truthful about the extent of the trauma. We need to provide adequate finance for adopted children – and their adoptive parents – to be given therapeutic resources to address the complex issues involved. The long-term savings to the Exchequer would be considerable. Early intervention is well-known to obviate or reduce the need for future costly input."

The research increasingly tells us that early brain development has broad scale implications for life - be it school, relationships, family life, recreational activities - and that these are life long impacts. As a side note, these impacts are affecting people's capacity to even be successful with their careers as adults.

Given how broad ranging this research, why would we take a known vulnerable population, children being adopted from child protection, for example, and not do all that we could to focus on building as much brain strength as possible? As the magistrate suggests, that requires significant intervention over time.

As government budgets get cut, short term therapeutic interventions become fashionable. With this population, they don't work. One only has to look at the work of Dr. Bruce Perry to see this (his books should be essential reading for anyone who works with this population). The work of Terry Levy and Mike Orlans also shows this.

Adoption is only part of the solution but in the western world it has too often been seen as THE solution.

Tuesday, November 9, 2010

Paying for Sterlization

Child protection, by its very nature, will enter a family and feel like a divisive force to many. This may be true whether the child remains in the home or not. Parents being told that things must change - and being so told by powerful outsiders - can naturally garner some resistance.

For parents who are faced with very large struggles (addiction, serious domestic violence, extremes in poverty, mental illness to name the big ones), child protection often means that their children will be taken from them. An incapacity to make some fairly significant improvements will mean that several will lose their children through permanent guardianship orders or termination of parental rights. Those children will grow up in foster or adoptive homes with varying degrees of success or failure.

Cat McShane, writing in last Sunday's Guardian newspaper in the UK, spoke about Project Prevention. This is a very controversial effort by an organization to essentially stop drug addicts from procreating. As it says on its web site, "Project Prevention offers cash incentives to women and men addicted to drugs and/or alcohol to use long term or permanent birth control." Those who believe that there is a morality to ending the inter generational cycle of dysfunctional families will find some solace in this approach. Critics argue that the project simply pays addicts money to buy drugs in exchange for their fertility - an exchange that some might see as a pretty cheap exchange but not unlike the desperate exchanges that addicts will make many times in their lives.

Those who work in child protection will see some merit in the exchange as they go about their daily work with children affected in utero by alcohol and drugs as well as those who have come to live in the utter chaos of their parent's attempts to survive from one fix to the next.

McShane's column shows that addicts can turn their lives around and go on to become successful parents. He perhaps dismisses too easily the costs being paid by the children born into addiction. His stories of hope are welcome but so must also be the reality for the children who live with the legacy of their parent's addictions.

This is a tough moral debate - pay for avoiding the huge costs to society arising from caring for these children or prevent the births in the first place. While Project Prevention is voluntary, one is reminded of prior efforts by society to prevent unfit parents from giving birth. It reminds me of the eugenics movement where society sterilized thousands of mentally retarded people in order to ensure that they did not have children. While these were forced sterilizations, the moral judgment of who is fit to have a child and who not is a driving force in both.

The other side of the coin is seen in families who adopt children from the system. As someone who has worked with adoptive families, I am struck by the degree to which they are unprepared to deal with the challenges of children born into abuse, neglect and addiction. Thus, another Guardian article last weekend by Tracy McVeigh was not surprising as the challenges faced by these families was outlined - greater challenges than expected; not being told the full truth about the child and not having the full range of supports needed for the challenges being faced. This article is worth a read

McShane's article is also worth a read as it is thought provoking. You can find it at

You can find Project Prevention at