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
Friday, August 19, 2011
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.
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
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.
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.
Monday, July 25, 2011
Mental Health and Child Protection
A new report from Australia helps to highlight the connection between mental health issues and child protection. This is an important topic, as anyone working directly with cases will know how frequently the connection exists. The report is titled, "Keeping the child in mind: Child protection practice and parental mental health" makes an important point - It is not the presence of the mental illness that matters but the impact that it has on parenting. Practitioners will know that there are many cases where parents with mental illness still manage to provide at least good enough parenting. The same can be said with those suffering chronic physical illnesses.
As well, practitioners must also pay attention to what supports exist that can remediate the impact of the illness.
The authors sum up the parenting point quite well stating, "Parental diagnosis of mental illness alone is not sufficient to cause problems for the child and family. Rather, it is how the illness affects the parent’s behaviour and familial relationships that may cause risk to a child. The age of onset, severity and duration of the parents’ mental illness, the degree of stress in the family resulting from the parents’ illness, and most importantly, the extent to which the parents’ symptoms interfere with positive parenting, such as their ability to show interest in their children, all influence the level of risk." (p.10).
A fundamental question is what is the impact on the child in areas such as attachment, development and their own mental health. Will they be required to assume responsibilities beyond their capacity which may also include looking after the ill parent?
Mental health may also be episodic meaning that children can have experiences that vacillate between rather good parenting to neglectful or abusive. Their world may be quite unpredictable. This illustrates the need for good assessment and attempts to ensure parents are connected to ongoing services. Their insight might be impaired by the mental health issues resulting in challenges with cooperation between the parent and child protection.
The implications for parenting capacity assessments are noted on p. 12, "In their view, parenting capacity assessments need to be comprehensive and based on:
• an acknowledgement of the family’s strengths
• child-parent observations in natural settings over a period of time, recognising the often episodic nature of mental illness
• linkage of specific qualities and functional aspects of parental behaviour with protective or risk factors for the child
• a multi-method, multi-source approach that includes, where possible, information from mental health professionals who are familiar with the parent’s mental health status."
A good assessment matters as mental health issues, which include substance abuse, require treatment that is a good match with the parent and the issues. Resource availability can, of course, limit the best choices but understanding what they should be helps to develop the best plan. These can be challenging cases to work when the mental illness is at its height as resistance and poor insight are common. This is partially why so many of these cases result in some period of time in foster care for the children. Good resources and supports that reduce the frequency and intensity of the symptoms will reduce entry into foster care - a benefit for the children! Of course, that requires parental willingness which may be its own challenge.
This research highlights the specific challenges of Borderline Personality Disorder as one illness that presents often in child protection populations. "Recent research has emphasised the relationship between borderline personality disorder and early childhood trauma and adversity and suggests that the core features associated with this disorder will have an immediate impact on parenting, compromising the promotion of attachment security and healthy child development. Parents with borderline personality are ‘high risk’ parents, who, as this study has demonstrated, are likely to be over-represented in child protection services. Children of mothers with borderline personality disorder present with various clinical syndromes and types of emotional disturbance (Newman and Stevenson 2005:386). There are significant community and public health implications if the needs of these parents remain unaddressed – borderline personality disorder can impact on parenting and on the child over time and across generations.'(p.44). Treatment can often be long and resources limited for BPD patients.
The report also highlights the need for inter agency cooperation - a theme that we have seen often in child death inquiries, for example.
Reference:
Jeffrey, H., Rogers, N. & Hirte, C. (2011). Keeping the child in mind: child protection practice and parental mental health. South Australia: Department of Families and Communities. Downloaded 2011/06/25 from http://www.dfc.sa.gov.au/pub/LinkClick.aspx?fileticket=ec1nlu8xxAo%3d&tabid=607
As well, practitioners must also pay attention to what supports exist that can remediate the impact of the illness.
The authors sum up the parenting point quite well stating, "Parental diagnosis of mental illness alone is not sufficient to cause problems for the child and family. Rather, it is how the illness affects the parent’s behaviour and familial relationships that may cause risk to a child. The age of onset, severity and duration of the parents’ mental illness, the degree of stress in the family resulting from the parents’ illness, and most importantly, the extent to which the parents’ symptoms interfere with positive parenting, such as their ability to show interest in their children, all influence the level of risk." (p.10).
A fundamental question is what is the impact on the child in areas such as attachment, development and their own mental health. Will they be required to assume responsibilities beyond their capacity which may also include looking after the ill parent?
Mental health may also be episodic meaning that children can have experiences that vacillate between rather good parenting to neglectful or abusive. Their world may be quite unpredictable. This illustrates the need for good assessment and attempts to ensure parents are connected to ongoing services. Their insight might be impaired by the mental health issues resulting in challenges with cooperation between the parent and child protection.
The implications for parenting capacity assessments are noted on p. 12, "In their view, parenting capacity assessments need to be comprehensive and based on:
• an acknowledgement of the family’s strengths
• child-parent observations in natural settings over a period of time, recognising the often episodic nature of mental illness
• linkage of specific qualities and functional aspects of parental behaviour with protective or risk factors for the child
• a multi-method, multi-source approach that includes, where possible, information from mental health professionals who are familiar with the parent’s mental health status."
A good assessment matters as mental health issues, which include substance abuse, require treatment that is a good match with the parent and the issues. Resource availability can, of course, limit the best choices but understanding what they should be helps to develop the best plan. These can be challenging cases to work when the mental illness is at its height as resistance and poor insight are common. This is partially why so many of these cases result in some period of time in foster care for the children. Good resources and supports that reduce the frequency and intensity of the symptoms will reduce entry into foster care - a benefit for the children! Of course, that requires parental willingness which may be its own challenge.
This research highlights the specific challenges of Borderline Personality Disorder as one illness that presents often in child protection populations. "Recent research has emphasised the relationship between borderline personality disorder and early childhood trauma and adversity and suggests that the core features associated with this disorder will have an immediate impact on parenting, compromising the promotion of attachment security and healthy child development. Parents with borderline personality are ‘high risk’ parents, who, as this study has demonstrated, are likely to be over-represented in child protection services. Children of mothers with borderline personality disorder present with various clinical syndromes and types of emotional disturbance (Newman and Stevenson 2005:386). There are significant community and public health implications if the needs of these parents remain unaddressed – borderline personality disorder can impact on parenting and on the child over time and across generations.'(p.44). Treatment can often be long and resources limited for BPD patients.
The report also highlights the need for inter agency cooperation - a theme that we have seen often in child death inquiries, for example.
Reference:
Jeffrey, H., Rogers, N. & Hirte, C. (2011). Keeping the child in mind: child protection practice and parental mental health. South Australia: Department of Families and Communities. Downloaded 2011/06/25 from http://www.dfc.sa.gov.au/pub/LinkClick.aspx?fileticket=ec1nlu8xxAo%3d&tabid=607
Thursday, July 21, 2011
Supporting visits between parents and children in foster care
Research has been telling us that children have a much higher chance of returning to parental care when there are frequent high quality visits with their parents. This is good news for the goals of family preservation and reunification. There is now a very useful, short guide to helping make those visits effective. It was published in April 2011: Family Visitation in Child Welfare Helping Children Cope with Separation while in Foster Care. This US publication has widespread value despite a few references to US legislation. The report highlights its purpose:
"Research shows (Weintraub, 2008) that children who have regular, frequent contact with their family while in foster care experience:
• A greater likelihood of reunification
• Shorter stays in out-of-home care
• Increased chances that the reunification will be lasting
• Overall improved emotional well being and positive adjustment to placement
In order to make the most of visits, families need to be prepared for the purpose of visits, what is expected during visits and how visits may change over time in length and frequency."
It provides practical steps to make these visits effective and shows how they can change to increase usefulness over time. The report can be accessed at:
http://www.partnersforourchildren.org/pocweb/userfiles/Best%20Practice%20Brief_visitation_final.pdf
"Research shows (Weintraub, 2008) that children who have regular, frequent contact with their family while in foster care experience:
• A greater likelihood of reunification
• Shorter stays in out-of-home care
• Increased chances that the reunification will be lasting
• Overall improved emotional well being and positive adjustment to placement
In order to make the most of visits, families need to be prepared for the purpose of visits, what is expected during visits and how visits may change over time in length and frequency."
It provides practical steps to make these visits effective and shows how they can change to increase usefulness over time. The report can be accessed at:
http://www.partnersforourchildren.org/pocweb/userfiles/Best%20Practice%20Brief_visitation_final.pdf
Wednesday, July 20, 2011
Notes on soon to be published research
The journal Children and Youth Services Review has several articles forthcoming that are of clinical importance in child protection.
Daniel has an article, "Fostering cultural development: Foster parents’ perspectives" which is a qualitative review done with a small group of foster parents in two Canadian provinces. It looks at trans racial foster care. This is quite important as there is a shortage of non-caucasian foster homes while there is a far greater representation of non-caucasian children, particularly Aboriginal children, in foster care. She concludes, "The core theme that emerged, based on my interpretation of 9 participants responses, was that foster parents were ‘fostering cultural development’ in their homes as well as their respective communities." While the study is small, it is a look at an under studies issue in Canada.
In another study forthcoming in this journal, Grant and her colleagues will publish "Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not". This is such an important topic as substance abuse issues are so prevalent in child protection populations. They note, "Mothers who have substance abuse disorders typically have psychosocial characteristics that put them at risk for poor or disrupted parenting, including experiences of early childhood neglect and abuse." Reunification efforts with this population can be challenging. "A significant body of research has examined the role of service delivery in family reunification among mothers who have substance abuse problems, and confirms the benefits of comprehensive, multidisciplinary, and accessible services being available and tailored to the mothers’ needs." Multi agency cooperation is key to successful intervention.
Too often I have seen efforts made with one parent the focus (typically the mother) with little attention paid to a partner, particularly if that partner is a part time member of the family unit or not the biological father. This research notes, "...for mothers who completed inpatient treatment the odds of reunification were increased if they also had a partner who was supportive of them staying clean and sober." This research also notes the complex nature of substance base issues and the need to match services with those needs which include such things as mental health services, housing and health needs.
In another Canadian study, Guibord and colleagues from the University of Ottawa wrote, "Risk and protective factors for depression and substance use in an adolescent child welfare sample". The abstract of the article nicely outlines their conclusions and really emphasizes how important caregiver relationships are. "Results from logistic regressions indicated that adolescent females were at higher risk of experiencing depression than males, and increasing age was associated with increased risk for substance use. Turning to protective factors, results indicated that the greater the perceived quality of the youth–caregiver relationship, the lower the risk for mental health difficulties (i.e., depression, substance use). Moreover, participation in extracurricular activities appeared to protect youth against depression or substance use. Results imply that the youth–caregiver relationship and involvement in extracurricular activities are important areas to consider to promote the well-being of maltreated youth in out-of-home care." In essence, creating something stable and approximating a typical developmental trajectory matters. The converse implication is that multiple unstable placements are likely to be high risk for youth.
I was also fascinated with another study given work that I do with adolescents with substance dependency problems and their families. Hornberger and Smith have an article upcoming, "Family involvement in adolescent substance abuse treatment and recovery: What do we know? What lies ahead?" They conclude "amily involvement should be an essential part of intake, treatment, and recovery planning, as well as the foundation for effective parent–professional partnerships." I would go further based on my own research that is about to be published in Procedia in which I note that families also need treatment to help with the impact of substance abuse problems on family functioning. I particularly like Hornbereger and Smith's conclusion "The goal of family involvement is not only to involve families in the treatment process, but also to develop collaborative partnerships that bring the expertise, resources, and experiences of families and professionals together. Such collaborative partnerships are necessary to help adolescents and their families not only understand the disease of addiction but engage in treatment, sustain recovery, and heal from the impact of substance abuse. In treatment, when families and professionals work together in the best interests of the adolescent and impacted family members, positive outcomes occur. When there is increased family involvement, family members have greater owner- ship of the treatment plan, which in turn increases their motivation and participation, and thereby improves outcomes."
In yet another important piece of research to be published, Jones looks at foster care youth in the 3 years after moving to adulthood. She notes " Factors which facilitated successful adaptations were: a period of transitional residence after foster care, good support systems including family and former social workers, and a commitment to further education." This emphasizes other research that transitional supports are so needed. Given that children growing up in biological homes require support to adulthood why would we think it would be any different for foster children who typically face greater odds.
Good research helps us to have better clinical interventions. These articles add to our knowledge.
Daniel has an article, "Fostering cultural development: Foster parents’ perspectives" which is a qualitative review done with a small group of foster parents in two Canadian provinces. It looks at trans racial foster care. This is quite important as there is a shortage of non-caucasian foster homes while there is a far greater representation of non-caucasian children, particularly Aboriginal children, in foster care. She concludes, "The core theme that emerged, based on my interpretation of 9 participants responses, was that foster parents were ‘fostering cultural development’ in their homes as well as their respective communities." While the study is small, it is a look at an under studies issue in Canada.
In another study forthcoming in this journal, Grant and her colleagues will publish "Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not". This is such an important topic as substance abuse issues are so prevalent in child protection populations. They note, "Mothers who have substance abuse disorders typically have psychosocial characteristics that put them at risk for poor or disrupted parenting, including experiences of early childhood neglect and abuse." Reunification efforts with this population can be challenging. "A significant body of research has examined the role of service delivery in family reunification among mothers who have substance abuse problems, and confirms the benefits of comprehensive, multidisciplinary, and accessible services being available and tailored to the mothers’ needs." Multi agency cooperation is key to successful intervention.
Too often I have seen efforts made with one parent the focus (typically the mother) with little attention paid to a partner, particularly if that partner is a part time member of the family unit or not the biological father. This research notes, "...for mothers who completed inpatient treatment the odds of reunification were increased if they also had a partner who was supportive of them staying clean and sober." This research also notes the complex nature of substance base issues and the need to match services with those needs which include such things as mental health services, housing and health needs.
In another Canadian study, Guibord and colleagues from the University of Ottawa wrote, "Risk and protective factors for depression and substance use in an adolescent child welfare sample". The abstract of the article nicely outlines their conclusions and really emphasizes how important caregiver relationships are. "Results from logistic regressions indicated that adolescent females were at higher risk of experiencing depression than males, and increasing age was associated with increased risk for substance use. Turning to protective factors, results indicated that the greater the perceived quality of the youth–caregiver relationship, the lower the risk for mental health difficulties (i.e., depression, substance use). Moreover, participation in extracurricular activities appeared to protect youth against depression or substance use. Results imply that the youth–caregiver relationship and involvement in extracurricular activities are important areas to consider to promote the well-being of maltreated youth in out-of-home care." In essence, creating something stable and approximating a typical developmental trajectory matters. The converse implication is that multiple unstable placements are likely to be high risk for youth.
I was also fascinated with another study given work that I do with adolescents with substance dependency problems and their families. Hornberger and Smith have an article upcoming, "Family involvement in adolescent substance abuse treatment and recovery: What do we know? What lies ahead?" They conclude "amily involvement should be an essential part of intake, treatment, and recovery planning, as well as the foundation for effective parent–professional partnerships." I would go further based on my own research that is about to be published in Procedia in which I note that families also need treatment to help with the impact of substance abuse problems on family functioning. I particularly like Hornbereger and Smith's conclusion "The goal of family involvement is not only to involve families in the treatment process, but also to develop collaborative partnerships that bring the expertise, resources, and experiences of families and professionals together. Such collaborative partnerships are necessary to help adolescents and their families not only understand the disease of addiction but engage in treatment, sustain recovery, and heal from the impact of substance abuse. In treatment, when families and professionals work together in the best interests of the adolescent and impacted family members, positive outcomes occur. When there is increased family involvement, family members have greater owner- ship of the treatment plan, which in turn increases their motivation and participation, and thereby improves outcomes."
In yet another important piece of research to be published, Jones looks at foster care youth in the 3 years after moving to adulthood. She notes " Factors which facilitated successful adaptations were: a period of transitional residence after foster care, good support systems including family and former social workers, and a commitment to further education." This emphasizes other research that transitional supports are so needed. Given that children growing up in biological homes require support to adulthood why would we think it would be any different for foster children who typically face greater odds.
Good research helps us to have better clinical interventions. These articles add to our knowledge.
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