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Saturday, June 30, 2012

Let the Sandusky convictions mean something


Throughout North America, if not in many parts of the world, the case of former Penn State coach Jerry Sandusky was followed closely. There may well have been a sigh of relief at his conviction on 45 charges. Some will think justice has been done and with Sandusky, maybe it has. But little such satisfaction should exist.

The larger question is how does a Sandusky come to exist for so long in society without intervention. His is hardly the first such case. Indeed, in the same week that Sandusky was convicted, Monseigneur Lynn was convicted in Philadelphia for assisting in the cover up of abuse by priests in the Roman Catholic Church. CNN is reporting  that Penn State not only likely knew what he was doing but chose to not report it.

Then there are other cases in Canada such as Graham James who sexually abused minor hockey players for years. There was the Mount Cashel orphanage in Newfoundland where the Christian Brothers of Ireland physically and sexually abused boys placed in their care. Canada also saw the rampant abuse of children in the Residential Schools, with the last one closing as recently as 1996. The impact on Aboriginal families in Canada was profound. Many have yet to recover both from the abuse and the extensive fracturing of family systems.

If society truly wishes to see the end of these horrific stories of abuse, then it must be willing to open the proverbial Pandora’s Box and talk about what has and is going on. Sandusky is a high profile case in which some of his former victims found the strength to come forward and tell their story. As so often happens, their disclosures come years after the abuse occurred. Victims routinely fear disclosing because the perpetrators often occupy positions of power over the child – be it a parent who threatens harm if they disclose or a person in authority such as Sandusky whose position is such that victims typically feel they will not be believed. Many victims mistakenly feel that the abuse was somehow their own fault.

The recent report on the failure by the Boy Scouts of Canada to properly address the issues of sexual abuse perpetrators amongst their midst shows that one of the solutions is better institutional policies and responses. Without them, sexual abusers remain hidden to carry on.

Secrecy is one of the most potent tools that abusers have in order to keep abusing.  To change this, we need to allow children to tell their story with confidence that they will be believed. But we also need institutions that are willing to hear those children.

Most children who are being abused will not have their situation brought to anyone’s attention. Thus, it is up to ordinary Canadians to decide that abuse should stop and be willing to speak up when they see it. Failure to do so, is to give it tacit approval.

Cases like Sandusky serve a purpose. They create conversation and awareness. These high profile cases are rare. It is the far less visible cases that require us to act. Sandusky could get away with it because, like so many abusers, he was in a position of power. Why are we so willing to turn a blind eye to such people whether they be coaches, priests, teachers or other professionals and carers for children? The tide will start to turn against sexual abuse when we call out the powerful people in children’s lives who break the trust granted them with our children. 

As Eldridge Cleaver said, you are either part of the problem or part of the solution. Become part of the solution. As a nation, we need to raise awareness of the impact of abuse and help to create solutions. We can stop abuse by supporting families so that their children are safe. Families that need help will need to be able to find it in communities across the country. If abuse occurs outside the family, we can make it safe for our children to tell. You can do this by hearing the voices of children and making sure that a child who discloses is given a safe place to tell their story. You might be that person.

Saturday, June 23, 2012

Why Sandusky matters

The conviction of former Penn state coach Sandusky matters a great deal for child protection. And no, it should not act as the basis for fear mongering that it will lead to more unwarranted apprehensions of children by child protection. Such a suggestion is based upon the notion that child protection workers are incapable of critical thinking when considering cases.

The fear might be that politicians will now try to gain political capital by making pronouncements that they will enact laws that will ensure that there will never be another Sandusky on their watch. That is politics and bad policy.

But Sandusky does matter because it sends to society some very powerful messages. To begin with, it means that the powerful who abuse can be held accountable. It means that the stories of abuse in the past can still be brought forward and the abuser convicted. It means that systems keeping these dirty little secrets should no longer be tolerated in society and that those systems should be held accountable.

Sandusky's defence lawyers argued that one of the motivations for the victims was to be able to sue and gain money. Yes, Sandusky and Penn State should be held accountable and that might mean paying money as a form of restitution. But there is no amount of money that will make up for the permanent, negative impact that sexual abuse will have on a child. There is no mistaking that such abuse creates life long changes that affect all aspects of a person's life.

There is also the good news in the conviction of Msgr. William J. Lynn. He is also in Pennsylvania. He was convicted for assisting the Catholic Church in covering up the sexual abuse by priests. This also opens the door for further accountability by institutions and systems for what goes on by those they supervise.

These convictions will not stop sexual abuse. They are public pronouncements that society is one step closer to taking strong stands that it is wrong and it will be something that society will take on stand on and send messages that it should not be tolerated. I should say will not be tolerated but I worry that there are still elements of society where it is going and the systems have yet to take the needed stand. Maybe this will crack open some of those doors.

Maybe also, these convictions will make it easier for other victims to step forward and tell their stories.

Wednesday, June 20, 2012

Parenting interventions can work --- and save money

Research published today in the journal, Research in Social Work Practice has shown that evidence based parenting interventions can save money and be effective. The frequency with which cases were subject to reinvestigation were reduced in the state where the program was used. Based on the Nurturing Parent Program (NPP) the researchers were able to show these gains. Not only are there economic benefits but one must also consider that this means less intrusion by child protection over the long term in many more families. It also means increased family preservation.

As other research has shown, keeping families together at a level that is at least good enough reduces other long term costs when compared with children raised in foster care. There is less difficulty with mental health, employment, school completion and crime. These cost benefits were not even considered in this current research.

Reference:

Maher, E.J., Corwin, T.W., Hodnett, R., & Faulk. K. (2012). A cost-saving analysis of a statewide parenting education program in child welfare. Research in Social Work Practice, published online 2012/06/13. doi: 10.1177/1049731512449873.



Monday, June 18, 2012

Assessing parent in drug manufacturing cases

Two colleagues and I have just published an article on assessing parents for child welfare in drug manufacturing cases.


Abstract
Child protection services frequently become involved with families engaging in substance abuse, and addiction, with a growing presence of drug manufacturing as an important component of the case. Assessors are called upon to consider how this impacts parenting capacity. However, while there are many protocols for assessing substance abuse and dependency, little attention has been paid to how to consider drug manufacturing and parenting capacity. The authors suggest a protocol that will guide assessors on determining the level of risk for children and the impact drug manufacturing may be having on parenting.
The article is published in the Michigan Child Welfare Law Journal in the Spring 2012 issue. It can be found at this link

Reference:

Choate, P., Harland, D. & McKenzie, A. (2012). Assessing parents for child protection in drug manufacturing cases. Michigan Child Welfare Law Journal, 14 (3), 10-19.



Friday, June 15, 2012

Dennis and Terence O'Neill

During World War II Dennis O'Neill was murdered by Mr. and Mrs. Gough. The death occurred in rural England. It occurred while these two boys were placed with them as foster children. During their stay with the Goughs, two other foster children were removed from their care as the home was deemed as quite unfit. Dennis died but his brother Terence barely survived. On the very, very few occasions that child protection systems interviewed the boys, they were either under the watch of the Goughs or were too afraid to speak up. The abuse grew over time until the brutal night that Dennis would be killed.

What is fascinating about this case is the amazing similarity to present day cases - children who were moved about within the foster care system; rarely seen by child protection workers; failure of information to properly flow between those who could have saved Dennis; failure to properly inspect the Gough house; failure to have the children properly assessed by a physician.

It is sad to see, some 60+ years later, the same mistakes being made by child protection systems.

Terence O'Neill has written an autobiography of his story in the book, Someone to Love Us. In it he tells of the unstable journey through the child protection system of the day. What is even more fascinating, is the story of his life afterwards. He wrote the book only a few years ago - in his seventies.  In the book, you get to experience the trauma and its legacies throughout the lifespan. How the damages of childhood becomes the hungry ghost of adulthood.

This is a book that anyone interested in child protection should read.

Wednesday, June 6, 2012

Liability Chill in child protection

The notion of liability chill is not unknown in various endeavours. Essentially, an enterprise begins to behave in a protective fashion to protect itself from liability claims. Often, this can mean conservative practices. In child protection, it can mean an increase in children being brought into care. It can also mean a risk aversive approach to clinical practice. Rather than take a reasonable chance on a parent or family reunification, it can lead to being more intrusive or taking longer to consider the possibility of return to parental care.

Two unrelated cases - one on the USA and one in the UK - may well lead to liability chill but, if looked at for the clinical lessons that both offer - should not lead there at all. Yet, both cases can scare social workers.

In the first case in North Carolina (the case of Aubery Kina-Marie Littlejohn), the child protection agency and social workers are being sued for the failure to protect a 15 month child from the fatal abuse of a parent. The Republic notes that:

The new complaint filed in Swain County Superior Court names the county DSS as a defendant along with seven current and former social workers, including the former head of the agency, Tammy Cagle. 

The lawsuit goes a bot further and raises an issue that is resonate across North America, Australia and New Zealand - the nature of child protection involvement with Aboriginal populations. In this case, the allegation is that not enough is being done to protect children within these populations. This is a dangerous approach - on the one hand, children regardless of where they live deserve a vibrant and effective child protection service. Thus, no part of society should receive less service. Yet, there is the real concern that child protection might target populations deemed less able to care for their children (see the prior post on racial bias). The Aboriginal populations have received racially based interventions. Care must be taken to not return to those ways. If this case were to succeed, it has the potential to raise the idea that Aboriginal populations may need targeted services. They do not need to be ignored but neither do they need to be singled out.

The second case in the UK has seen a social worker, David Alexander Fry, struck off as a registered social worker. He was found to have failed in many areas of practice. What is worrisome is that the General Social Care Council (GSCC) felt that it was the social worker's job to raise concerns that his case load was too high to manage. Perhaps so, but where was the responsibility of the management to effectively supervise the worker and manage the volume of cases assigned.

This is not to take away from the rather serious clinical failings of the worker. As CommunityCare.co.uk reports:

He also had a number of different team managers and received supervision only three times during that five-month period...“If the registrant was unable to keep up with his workload and record keeping, he should have done more to bring that to the attention of his managers, even allowing for the fact that those managers were constantly changing,” the committee said.
 That is bad management. A worker might well start to take cover and try to protect themselves in such a situation. Sure, good case management does that but so does "C.Y.A." case management. Clients suffer when that occurs. It is one thing to hold the worker accountable for poor social work - but do the same for poor supervision and management.

All of this is not to say that social workers should not be held accountable - like any profession they should be - but care should be taken to ensure that the liability is for the right thing.

Friday, June 1, 2012

Engaging parents in change


Research has suggested that the relationship between the social worker and the family is crucial for effective intervention in child protection. However, social workers often find themselves stuck in the dual role of both trying to assist a family and gathering forensic evidence. When parents perceive that the forensic role is the primary function, it will be hard for them to buy into the notion that the social worker is there to help. It's a bit like that old adage "Hi. I'm from the tax office and I'm here to help". Who of us feels like that is a likely outcome of a visit from the tax office. For many parents, they feel the same way with child protection workers.

With that in mind, an new article from the United Kingdom was most welcome. Platt, from the University of Bristol, addresses the conflict for parents. One area that he addresses that I think is most useful, is address the utility of the classic stages of change model that DiClemente and Prochaska wrote about. Platt suggests that it may not be appropriate for use as a model for this population. Of course, the model was developed for use with addiction.

It might be better to think about readiness for change.

We must also be wary of using engagement as the criteria for success in child protection. Is that doing what is needed to get the worker to go away or is it about meaningful change. Thus, what is happening matters more than the appearance of something happening.

Multidimensional or integrated models of engage- ment appear to offer the best way forward. Engage- ment with services is understood as a function of multiple influences, including caseworker and pro- gramme effects, as well as the circumstances of the client or patient and their interaction with those services (pp. 139-140).
Platt also reminds us that the focus of change needs to about the child - how is the intervention making the family system better for the child? Change that does not improve that may be good for the parent but child protection is about the child. Does the parent see the cause of the issues for the child as serious and thus believes that change is needed? Can the parent see that as important for the child?

Platt talks about several important factors to consider:

* internal and individual determinants;
* external determinants
* engagement as seen in behavior, attitude and interactional levels; and
* outcomes for both the parent and the child.

Platt also notes some research that helps us to understand how to work with mandatory clients. This improves engagement. He states:

Role clarification: Ensuring clarity about what the worker can or cannot do, what the client’s role is, and what each can expect from the other.
• Collaborative           problem         solving:           Providing       help    to address the problems that led to the current situa- tion; the worker needs to take a collaborative approach.
• Pro-social modelling and reinforcement: Identifying and trying to build on pro-social strengths, such as good relationships within the extended family. The worker should model ‘good behaviour’ by keeping appointments and doing what he/she said he/she would do.
• Challenge and confrontation: Extreme challenging is generally unhelpful although some level of chal- lenge is appropriate. Better outcomes occurred where clients believed that workers were clear about their own authority and how they might use it. (summarized from Trotter 2008). (p.146)

The point here is that effective case work can be done with mandatory clients when efforts are made to properly engage them.

Reference:

Platt, D. (2012). Understanding parental engagement with child welfare services: An integrated model. Child and Family Social Work, 17, pp. 138-148. doi:10.1111/j.1365-2206.2012.00828.x