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Thursday, October 27, 2011

It's the relationship in social work that matters in family preservation

OFSTED in the UK has just published an overview report that considers factors that keep children in families and out of foster care. It makes for fascinating reading. One of the key findings is that the nature of the relationship between the social worker and the family makes a significant difference. The report notes, " They were described as persistent, reliable, open and honest, which included being absolutely straight about what needed to change. They enabled the families to see that they had strengths and that change was possible." Being able to create hope matters.

Another finding was having a plan that made sense to the families. This included a focus that considered not only the needs of the children, but also the needs of parents, including fathers.

The study found that there are some factors that supported successful services included:

  • strong multi-agency working both operationally and strategically; this involved strategic analysis and understanding of the needs of this cohort of young people accompanied by investment in services to address these needs
  • clear and consistent referral pathways to services ␣ 
  • clearly understood and consistent decision-making processes based on
  • thorough assessment of risks and strengths within the family network
  • a prompt, persistent, and flexible approach, which was based on listening to the views of the young person and the family and building on their strengths
  • a clear plan of work based on thorough assessment and mutually agreed goals; regular review of progress and risk factors; robust and understood arrangements between agencies in respect of risk management; and clear planning for case closure and for sustainability of good outcomes.

The report further notes factors that were valued by families:

  • approaches which built on the strengths of the family
  • persistence, reliability and flexibility including the speed of response
  • open and honest communication, including in relation to what was and was not acceptable behaviour
  • an approach which valued family members, listening to, respecting and understanding the family’s perspective
  • clarity about expectations and what needed to be done to achieve improvements and the consequences for the family of not doing so
  • identifying and addressing the needs of all family members
  • working alongside the family to achieve shared goals
  • a clear plan to sustain progress when the involvement of the service ceased.
This all matters as it helps child protection to see that children can be kept out of care with the right supports that involve agencies working together on a clear case plan. However, if this is to work, there needs to be room for the worker to build the needed relationships. Workers must come onto a file with the probability that they will be there to see it through. Too many families experience an array of workers coming and going from their case. Why then should the family even try to invest in a relationship?

Perhaps a reverse question should be asked of child protection supervisors - If you want families to succeed and keep your entries into expensive foster care down, why would you change workers around often? It is my experience that families can more often than not count that the worker will change. 

Given this research data, that may be very counterproductive. From this report (and others) we see that real change is possible.

If you would like to read the whole report, it can be found at the Ofsted website.

Tuesday, October 25, 2011

The Aboriginal Experience in child welfare is still lacking

In Canada, there is a long and sordid history in the relationship between the child protection system and aboriginal peoples. The most famous historical examples are the Residential School system which I have written about before and the 60s scoop which saw a large number of aboriginal children apprehended and placed in non-aboriginal homes. There have been inquiries in Canada in the last few years that have shown aboriginal children are substantially over represented in the child protection systems of this country.

It is with this backdrop that two stories - one from Canada and one from the USA have particular relevance.

In the first, CTV news is reporting that advocates are attempting to bring to the United Nations a report "which argues that government funding for aboriginal health, education, housing and child welfare is not only inadequate, but is also lower than for non-aboriginal children."  The report was prepared by The First Nations Child and Family Caring Society of Canada and the ecumenical group KAIROS also points out that aboriginal child welfare is underfunded 22% compared to non-aboriginal child welfare. This suggests that systemic problems remain in Canada.

In the USA NPR is reporting that there is evidence that aboriginal children are also over represented in child welfare systems in that country. They also speak about the extensive practice of placing these children in non-native homes which creates cultural issues.

Some critics might argue that aboriginal children are so over represented in child protection systems because of the large scale social problems that arose from generations of oppression that has left many families dysfunctional with wide spread social problems. They might argue that, therefore, reservations, for example, lack a competent parenting cohort. This may have some merits as generations of children were taken away from families and placed in residential schools cut off from family and traditions while being abused in these schools.

There is no doubt a legacy from those years that is still rebounding throughout the aboriginal communities across North America. One suspects that we have yet to find good solutions and, as a result, we stumble around with seeing the need for strong systemic changes in how we deal with child protection issues in the aboriginal communities. What we are doing now seems not to be working well.

Saturday, October 22, 2011

The real problem of evidence

Three high profile cases in Canada raise the very troubling question that weak evidence can get in the way of protecting children. When balanced against the needs to preserve families, such a problem can leave children in need of protection unprotected.

In Central Canada, we have the trial currently underway regarding the honour killings of three teenage girls. Media reports from the trail indicate that at one point child protection authorities interviewed the girls who did not provide enough evidence to warrant keeping a file open. We may yet learn more about this as the trial evolves. The Globe and Mail reports that the charges are against "Mohammad Shafia, 58, his second wife, 41-year-old Tooba Mohammad Yahya, and their son, Hamed, 21, are accused of killing the couple’s three teenaged daughters, Zainab, Sahar and Geeti, and Mr. Shafia’s first wife, Rona Amir Mohammad, 53" Were the children too frightened to tell the truth? 

In the second case, the Los Angeles Times and CBC's Fifth Estate have teamed up to examine the case of Richard Turley who appears to have been a serial child molester who operated as a scout leader, amongst other roles with children. The Scouting organization in Victoria, B.C. has suggested that they lacked credible evidence with which to go forward to the police. Yet, they would take the step of moving him to a program that would involve fewer younger children and be under the supervision of a leader who was to ensure he was never to be left alone with children, according to a story running in The Calgary Herald

In both cases, apparent lack of evidence has led to an utter failure for the children who died or were harmed by systems hampered by lack of evidence. In the Scouts case, one might well argue that child protection reporting laws should have led the organization to report Turley to child protection authorities or the police anyway. They might well have left it up to those skilled in investigating these cases. Given the number of victims, there may have been a better chance that his activities would be discovered with good investigative work. In my view, Scouts was wrong to see lack of evidence as a reason to fail to act as they were the wrong authority to make the decision. It leads one to question the motives - was it lack of evidence or was it trying to protect the name of Scouting? The decision to move Turley  and put him under supervision is almost too reminiscent of how the Catholic church managed far too many cases.

The third case is in the BC Supreme Court decision of K.A.K. v British Columbia. As the decision notes, "The plaintiffs are six[1] of eleven children born to the defendants G.K. and M.H. They seek general and future pecuniary damages from the Province of British Columbia (the Crown) for the failure of the Ministry of Child and Family Development (MCFD or the Ministry) to remove them from their parents’ care when it was readily apparent that they were in need of protection. The Crown has admitted liability."  This is a very troubling case in which there was not a lack of evidence but perhaps a lack of appreciation of the evidence that was avilable. For example, the decision notes, "[30]         In February and March 1992 there were reports that the parents would not accept visits from social workers and in May 1992 MCFD closed the file “due to extreme resistance”. In July, K.N.K. was seen in hospital after a “near drowning”. She was examined by Dr. Paul Korn, a paediatrician, who understood that the child had been in a bath tub unattended. He kept K.N.K. overnight and released her the next day, observing her to be fine. He recommended that public health go into the home to make sure safety issues were addressed. It is not known if this was ever done."

Yet the decision also notes that child protection authorities also made several efforts to work with the parents to address the alcoholism and other deficiencies in the family. The efforts were apparently without long term success. For example, the decision notes many pieces of evidence that, when looked at in retrospect causes one to wonder who was looking at the large picture to see how much cumulative data there really was, ". She [the social worker] testified that she spoke to K.N.K. and her older sister K.A.K. and both denied any abuse. She also spoke to the parents, who provided explanations for the injuries. She was concerned about abuse of K.N.K. and wanted to make sure that the parents were involved in a parenting program and the children were visible in the community. She was also concerned about the impact of the home environment on the other children. She clearly recalled the children as non-verbal, demonstrating to her a lack of development or lack of stimulation. Ms. Dahl prepared a risk assessment on April 14, 1997. She determined that the concerns of physical abuse were not substantiated and the children were not then in need of protection." The decision shows a litany of such examples of mounting evidence both before this referenced time frame and after. It is a classic case, so it seems, of a failure to take a careful note of all the evidence that was available.

The memories of the older children are detailed in the testimony described in the Court's decision. The trauma that the children experienced. Reading the decision is disturbing because of just how much evidence there was and how much trauma the children experienced.

It would take some years before a parenting capacity assessment would be done. When that is done, the court notes that the assessor may be one of the first to have really interviewed the parents. As the decision notes, "Dr. Krywaniuk’s general impression was that this had been a highly dysfunctional family for a number of years. He found the parents to be highly defensive, minimizing various behavioural issues and denying the use of alcohol and drugs in the face of what he considered obvious evidence to the contrary. He felt that the children were influenced by the parents. With respect to the visit, he described a “passive quality” to the parents and said that there did not seem to be a lot of emotional commitment between the parents and children; the children seemed to be “just there”. It was his view that the children all had special needs in respect of behavioural, developmental and emotional issues and because of this they required a “better-than-average level of parenting.”
[80]         He expressed concerns about continued contact between the parents and the children:
There is at least some indication that, the longer the children stay in care, the more the older children disclose regarding abuse and family dysfunction. I think it is likely that the parents will continue to communicate their level of distrust to the children, undermining their recovery and potentiating them for further difficulties. The background information indicates that there is continued concern for the safety of the children, despite the parents’ protestations to the contrary. For example, there appears to be a denial of children’s problems and continued substance abuse. I understand that there is considerable bickering in front of the children and a general lack of authority. ... The older children have significant problems and I think it is likely that the younger children will develop along the same lines because of the parental attitudes."
The court will conclude that the victims deserve compensation. The decision states: "84]         In my view, the evidence establishes that all of the plaintiffs suffered extensive neglect by the parents M.H. and G.K. and that K.N.K. suffered serious, on-going physical abuse by M.H. Other than the testimony of K.N.K. and C.N.K., there is little direct evidence about what went on in the home prior to June 1999. However, there is a body of circumstantial evidence. The most reasonable inference to draw from the numerous reports to the Ministry and the various observations of the children by social workers and school personnel is that M.H. and G.K. led a lifestyle that involved the regular abuse of alcohol and at least intermittent domestic violence between the parents, all of which the children were exposed to, and persistent neglect of the basic needs of the children. The family moved often, the parents rarely provided proper accommodation and in general did not regularly attend to their children’s essential nutrition, hygiene and health care. On apprehension in August 1998, most of the plaintiffs had long-standing, severe, untreated head lice, C.N.K. had an untreated skin condition, M.K. and C.N.K. had terribly rotted teeth and K.N.K. had numerous physical injuries, all of which had been observed by others.
[85]         The Ministry had strong evidence that K.N.K. had been physically abused as early as March 1993, when she was examined by Dr. Hlady, and this continued over the years. Various people observed injuries on K.N.K. in 1996, 1997 and 1998. In 1998, Dr. Korn was extremely concerned for her safety should she be returned to her parents, for good reason. The multiple injuries that K.N.K. had when she was finally apprehended in May 1999 were serious. The evidence was quite overwhelming that they were non-accidental."
Thus, we see that this is a case where evidence was present and not properly acted upon. The Scouts case is one where evidence likely existed and was not properly disclosed. The honour killings case suggest that there was evidence that was hidden by the victims. In child protection, it is chasing the evidence that matters but that is often in conflict with the roles of helping and preserving families.