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Friday, August 19, 2011

Drug Endangered Children - An Update

As if to illustrate the point that care needs to be taken to properly consider whether children are at risk from parental drug use, the New York Times has a most interesting story on how New York may well over react and handle the same issue of small amounts of marijuana very differently from California.

What matters here is that the cases are being considered on perhaps the wrong grounds - i.e. a political statement about illegal drug use as opposed to considering alternative approaches that may better serve the interest of the children. It is hard to argue that in the circumstances reported by the New York Times that the outcome is serving that interest.

See the NYT article here: www.nytimes.com/2011/08/18/nyregion/parents-minor-marijuana-arrests-lead-to-child-neglect-cases.html?_r=2&emc=eta1

Wednesday, August 17, 2011

Tulir Centre for Prevention and Healing of Child Sexual Abuse

I had the opportunity to visit the Tulir Centre for the Prevention and Healing of Child Abuse. It is run by two quite amazing women who are able to talk about and confront one of the most difficult issues facing children across the world. This includes sexual abuse and assault, exploitation and trafficking. When I was in Turkey earlier this year, I also met two women running a centre for victims of child trafficking in Saudi Arabia.

I think that what struck me the most, is how often we are focused on the victims. We pay attention to the hurt that they experience - there is no doubt that is tragic. A hope is that women will increasingly find the strength to talk about what has been going on and be empowered to say no. But how do you say no to the person who is staring; the one who doesn't accept no; the person who feels that the sexual abuse is somehow normal.

this of course raises a very crucial piece of the puzzle - we must find ways to change the behaviour of boys. This is about ensuring that they no longer see teasing, sexual harassment and assault as in some fashion justifiable. That is a major educational goal that affects families throughout the world. It is hard work.

The centre also sees a growing problem here in India with the role that the internet plays. In the West, this is not news but serves as a very good reminder that much sexual harassment is done through the electronic means - texting, phone images, internet and other forms of instant messaging. Again, when I was in Turkey, an Australian researcher, Dr. M. Campbell, showed how powerful electronic tools are in keeping the harassment going 24 hours a day - and there is no safe refuge. You just can't get away from it particularly for technology dependent youth.

Child protection must go where issues develop and certainly what is acceptable for boys in a culture has profound impacts on what happens to girls.

They also spoke about something that we continuously see in the child protection world - the need to build strong and effective networks - no agency can go alone.

One point that was very powerful is the way in which NGOs are being used at times by sexual tourists (pedophiles) as ways to get into contact with children.

Their blog is worth following at http://www.childsexualabuseinindia.blogspot.com/

Their website is, by their own description, text heavy. But it also has some quite interesting material - http://www.tulir.org/ For those in South India it is in English but also in Tamil.


Sunday, August 14, 2011

Drug Endangered Children

As a result of the growth of meth labs in particular, we saw increasing concern about the risks for children in these environments. These included concerns that the parents would expose the children to unhealthy lifestyles that included use of drugs, presence of a criminal lifestyle and the violence that would go with that. It also meant that there would be concerns that the children would be neglected.

Much of the literature that can be found is focused on meth labs with a great deal of attention to the toxicity risks that can go with them. There are of course other production environments, particularly those related to marijuana.

New research brings into question some of the assumptions that have underpinned child protection thinking. Moller et al., (2011) in Toronto have produced research that suggests that the health status of children should not be seen as automatically compromised. They state, "Despite our findings that 30% of the children in our study tested positive for drugs of abuse in their hair, we found that the vast majority were in good health at the time of examina- tion, which was within 1 to 2 weeks from their removal from their homes. The rates of the mostly minor health issues ob- served were well within the range expected in Canada and other developed countries (Table I). The current protocol followed by Police and Children’s Aid Societies has been based on the assumption that the grow-houses and the individuals who operate them are not safe for children. It is not clear whether the risk of interrupting a nurturing parent- child relationship has been adequately considered in all cases" (In Press).

This reminds us that, in child protection work, we must be careful to ensure we are working with supported facts on a case by case basis as opposed to formulaic thinking that a risk will apply to all children in a particular situation.

Some other Canadian research has also challenged automatic thinking around drug use. "The findings of this study, consistent with the practices and insights of participants in our research, suggest that some mothers who use drugs and who have personal difficulties are still able to care for their children without intervention from child protective services" (Drabble & Poole, 2011, p. 143).

Both of these research conclusions can be difficult to accept and even more difficult for child welfare and courts to manage. Should they be willing to accept that some level of drug use may be acceptable if the needs of the child are being met?

As Drabble & Poole (2011) also note, some level of relapse is also normal in addictions. Again, how much is acceptable and how much is not. Clinically, I have tended to take the position that there are two factors in particular that need to be considered - what did the client do as a result of the relapse and the recency and duration of the relapses.

Both of these pieces of research cause us to reflect on some important assumptions that have become the norm in child protection thinking in manna quarters.

References:

Drabble, L & Poole, N. (2011): Collaboration between addiction treatment and child welfare fields: Opportunities in a Canadian context. Journal of Social Work Practice in the Addictions, 11, (2), 124-149. doi: 10.1080/1533256X.2011.570657

Moller,M., Koren, G., Karaskov, T., & Garcia-Bournissen, F., (2011) Examining the health and drug exposures among Canadian children residing in drug-producing homes. The Journal of Pediatrics, In Press. 10.1016/j.jpeds.2011.05.044

Saturday, August 6, 2011

Child Protection Critics - valid and not valid

Critics of child protection seem to fall into one of several groupings. This matters as a way to think about what you are reading. It allows the reader to bring critical analysis to what is being said. This is true of myself, of course.

My groupings of the critics go as follows:

1. The professionals – this includes academics, public policy makers and clinical practitioners. This group tends to approach the issues quite analytically and seek changes from a more pragmatic level. However, this group also includes some broad thinkers who seek to blend the practical with practice reform. A recent example is Harry Ferguson, a British academic who was once a frontline social worker. He has recently published a book suggesting some rather fascinating changes that include workers being very aware of their own experiences and how child protection work can trigger this.

2. The appointed overseers – This group includes those who have been positioned to engage large scale overviews typically of tragedy. One of the most famous examples is the Lord Laming review of the Victoria Climbe case in England. There are others in this role such as Mary-Ellen Turpel-Lafond, the child advocate in British Columbia, who has a longer term, ongoing mandate to review and publically report on child protection issues in that Canadian province. Serious Case Reviews in the UK, child death reviews in other jurisdictions are also examples of these roles.

3. The Media is another important set of critics, although they will often approach their role with a sensationalist bent. The stories are typically about something that went wrong and seek to hold someone accountable. There is often a target to the story and the media has, at times, simply got it wrong in terms of who they were going after or what the real issues were. The best example is the reporting of the Baby P case in the UK. The media has done some very good reporting, however, that has led to some rather excellent reforms or, at least, nudged systems to better practice. Good examples are the PBS Frontline reporting of the tragic death of Logan Marr by her foster mother or the CBC Fifth Estate story on the death of Jeffrey Baldwin by his grandparents.

4. The Advocacy groups – These often have the mask of professionalism and will have names that suggest they are some sort of professional think tank. They seem most evident in the USA. Yet, they typically have strong policy biases that they are promoting. They have a sense of what they believe child welfare work should look like and filter what they report and write from that perspective. Rarely will you see material that contradicts their agenda being reported by them and, if it is, it is being attacked. Thus, even when they report academic research, they are often disingenuous with it selecting out the bits that support their policy agenda.

5. Parents who have been affected by the system. In the majority of the cases that I can find, these are parents who have lost children to the system and feel quite betrayed by it. This is not an unexpected or unwarranted emotion although it is very difficult to judge the merits of a case by their reporting. They are quite naturally and understandably biased. They do not claim any neutrality. Yet their stories are important as they provide a human face to the impacts of child protection work.

6. The children – there are occasions when children get to tell their stories of growing up in the system or of having been part of the system. These are blends of success, challenges and failures. They too are important, as they are the real life experience of some who have lived the story. In the USA there is a film circulating that tells the story of a few former foster children. It is a difficult watch at times but also quite powerful.

In looking at the vast material that is available on child protection, I have found it important to carefully consider who is writing and what is their agenda.

Another area of concern is how terminology is used. As Faller (2007) has noted, there are cases that are substantiated and many that are classified as unsubstantiated. Many critics of child protection see that as proof that child welfare is interfering in families that need not be investigated. Unsubstantiated is about there not being sufficient evidence to draw a conclusion. It is not the same as saying it did not happen. Those cases are classified as did not happen or false allegations. That group might include situations where the allegation was made maliciously or where actions were misunderstood, for example. False allegations occur but research suggests that they are small.

Child protection deserves criticism when it fails to do its job – either by failing to protect or failing to provide good case management, which can avoid apprehensions and sustain family units. But criticism also needs to be carefully assessed to determine the agenda as well as the information included or excluded.