Termination of Parental Rights

I have just had this article published. It discusses some of the very real challenges we face when trying to address issues if Termination of Parental Rights

Termination of Parental Rights: A Commentary

on Ben-David

PETER W. CHOATE

Child Studies and Social Work, Mount Royal University, Calgary, Canada

Ben-David (this issue) introduced us to the complexity of the factors

that courts consider in termination of parental rights (TPR).

It is an opening to understanding which factors are taken into consideration

and how courts make these challenging determinations.

Yet there are other questions that must be asked before we truly

understand the TPR decisions made by courts across a variety of

legal jurisdictions. This commentary argues that we must take the

inquiry deeper, asking questions that will unpack the complexity

assisting researchers and clinicians. Thus, we will want to know

how courts weigh such important issues as the credibility of the evidence.

What is it about such factors as parental competence, failure

of remediation, and other issues identified by Ben-David that cause

courts to determine TPR is the best choice? Consideration is given

to how Ben-David’s work might be extended using a Canadian

perspective.

Journal of Family Social Work, 18:243–252, 2015

Make life "everyday" for foster children

I am fascinated by a study from the University of Leicester in the UK which looks at the value of simple everyday activities for children in care. It seems that engaging children in the kinds of typical day to day activities can positively impact the sense of well-being. This can be what seems mundane - take the children shopping; play games; help care for pets; get involved in fun activities like going swimming.

These various types of activities engage children with the family system and also expose them to low stress and rewarding experiences. It socializes the child in a different way than may be quite different than experiences prior to coming into care. These sorts of activities, the researchers note, help the children to find their place within the social environment. By being successful and belonging, they can then develop a sense of empowerment in their own world - they be become actors who can create positivity in their life and are not driven by protective reactivity.

This can also lead children into finding comfort and reward in activities that link them to prosocial environments and connections.

In the world of increasing budget constraints, ins't it wonderful to think of the power of these everyday types of activities when a child is included in them with the foster family and other peers. This can also mentor children into learning how to manage free time more constructively.

The report notes:

• The participation of young people growing up in care is constructed in binary ‘positive’ or ‘negative’ terms. This research has found that this perception can lead to facilitated activities being overvalued and everyday participation being undervalued. The self-expression found in some forms of everyday participation feeds into young people’s sense of autonomy, yet this is not always recognised. 

• Participation facilitated by the corporate parent and foster carers of young people in care has a positive influence on the choices young people make regarding their own everyday participation. But this works both ways and what they choose to do in their free time in turn influences their decision to engage with the types of participation on offer. 

•  Safeguarding the well-being of young people in care is a priority for social services and carers. Ensuring and upholding this priority affects and takes precedence in different aspects of the young persons everyday life, including their participation. The requirement to safeguard can interrupt or even prevent participation inside and outside of the home. This leads to young people in care being treated differently and at times can lead to their exclusion.  

• Participation for young people exists in different geographical locations. However, when a young person in care moves placement, participation can be disrupted or even discontinued. 

The latter point speaks to the need for stability so that children can make connections that they can then hold onto allowing them to expand their sense of place, belonging and worth.

If you would like to look at the report go here and follow the links.

BC Child welfare system broken?

The Representative for Child and Youth in British Columbia, Mary-Ellen Turpel-Lafond, suggests that the child welfare system in her province is broken. She made the comments in a report presented by the ATPN media. One issue that she raises is that, for Aboriginal children, too often funding is linked to the child being in care versus prevention efforts to keep children out of care. Turpel-Lafond has many case examples to back up her worry.

Prevention needs to address issues that child welfare is not set up to manage. Poverty is the main reason that Aboriginal children are in care. Child welfare cannot solve that. They can only respond to the effects of poverty which are typically seen in the form of neglect.

As a new federal government takes shape in Canada, now is the time for at least three core  Aboriginal child welfare issues to be tackled:

1. Start fully funding child welfare on reserves across this country;
2. Implement prevention programs to keep children out of care; and
3. When it is necessary to provide protection to child keep the child within the community and family system by providing needed supports for kinship care to be successful.

In my view, these are priorities. We should be getting them on to the agenda of this new government.

To view the ATPN report, go here.

The British Columbia Representative for Children and Youth Nails it Again

Mary Ellen Turpel-Lafond is the Representative for Children and Youth in British Columbia. She has just issued a report, The Thin Front Line that analyzes staffing and related problems in the province's child welfare system. It's a read that is relevant to child protection authorities across Canada and likely elsewhere.

She states that "The problems are systemic and have accumulated over time, worsening and not improving." She adds that the complexities of working in child protection have increased over time but there are fewer workers to manage these caseloads. This should sound familiar in many places.  She notes that workers have had to struggle with budgetary cuts, staff shortages, high turnover and pressure to meet strict timelines.

The government of B.C. says she is working with old data. Perhaps so, but the issues that Turpel-Lafond raises are hardly new. Thus, there may be some improvement but one doubts that the picture is much out of focus given what is seen in scrutiny of child protection throughout the Western world. Indeed, her themes very much mirror my own research on child protection errors. Her conclusions also strongly mirror reviews done by many authors.

Where she gets the story quite straight is in her major themes:

• Workloads are high and complex;
• Processes change and are not necessarily clinically focused;
• The issues that must be dealt with are often connected to long standing inequities that may be beyond the capacity of a worker to solve. An example is the legacy of the Residential Schools and the Sixties Scoop which decimated the parenting and family structure in Canada's First Nations communities;
• Bureaucracy is a burden that takes many hours away from clinical work;
• It's tough work so people leave and it's hard to get replacements quickly;
• The geography of Canada (in this case B.C.) means that many rural and remote communities get spotty services;
• Clinical supervision is required regularly but there are not enough supervisors to manage the needs;
• She found too many offices operating in crisis mode which tends to lead to "band aid" social work, as she put it.

Turpel-Lafond offers several recommendations which include:

• Sufficient budgets to address the staffing and workload issues;
• Improve the management systems to reflect the complexity and volume of cases;
• Track performance and respond to gaps or poor results;
• Get more First Nations workers in place.

She notes that there have been some positive steps such as the introduction of the Family Development Response to help support families with lower intensity issues. 

These are not new issues so perhaps the one question she did not ask that needs asking is "Why do these issues keep happening, time and again, from jurisdiction to jurisdiction?" In other words, we are consistently getting it wrong. So how can it be done better. Public reviews need to start talking about that versus repeating themes and recommendations we have seen so often --- or is that governments are not really committed to child protection beyond the band aids? Is that governments don't really want to tackle the complex socio-economic factors that lead to children being at risk - poverty, inter-generational trauma, mental health and addictions and so on?

Investigation in British Columbia may be asking the wrong questions

The Royal Canadian Mounted Police (RCMP) announced in B.C. what has been hailed as a groundbreaking investigation. They will look into the actions of care workers who were involved with a First Nations youth, Paige, who died as a young adult from a drug overdose. Paige's case was the subject of a scathing report by the B.C. Representative for Children and Youth, Mary-Ellen Turpel-Lafond.

Paige as an infant, child and youth

In that report, social workers are noted to have failed to properly assess her needs; failed to communicate between regions as she moved around the province; didn't persist in trying to work with her as she became more challenging to engage; allowed her to live in some of the most dangerous, drug addicted areas of the province and often saw her without arranging further contact with child protection authorities. She died at the age of 19. She had many problems including Marfan syndrome which left her with very challenging eyesight, medication and cardiac health issues along with her addiction, trauma history and likely mental health issues.

As the CBC reported on September 18, 2015, "Paige as taken to hospital or detox at lest 17 times after being found unconscious or incoherent; she changed schools 16 times; and she featured in more than 40 police files, mostly for public intoxication." Yet, these incidents generally did not result in filing a report to child protection in accordance with provincial legislation. Like most Canadian provincial child welfare legislation, B.C. requires professionals to contact child protection whenever they suspect that a child is in need of protection.

It is the failure of authorities to make these reports that is the subject of the police investigation. But are they asking the right questions? It's tempting to be satisfied that the police may hold these workers accountable for their failures. That may make many professionals more aware although that might also lead to flooding the system with reports and more children coming into care. There can be a "fear chill" arising from such police efforts.

Despite the merits of a police investigation, it may be that the wrong questions are indeed getting asked. I find myself wondering (as I have with virtually all of the over 900 child welfare practice reviews I have read) what structural conditions lead to these kinds of failures.

• What causes professionals to believe that a report should not be done?
• What allows workers to believe that hard to reach youth are so challenging that you let them be in dangerous situations?
• What circumstances lead workers to fail to gather data from others who have worked with a youth?
• What did professionals believe would make a call to child welfare not worth doing?
• What is that professionals did not understand about their duty to report or has past experience caused them to believe that such calls are not worth doing because they cannot see any changes occurring?
• What kinds of supervision exists to support these decisions?

Yes, it is worth asking why these workers did not do what should be done but the questions are much broader. There has never been a prosecution under this section of the B.C. legislation. Turpel-Lafond hopes that this will be a turning point. I fear it may not be the one she wants. How many professionals will now decide that working with child protection cases should be avoided, for example.

Taking a resiliency approach

One of the challenges in child protection, is being faced with an onslaught of significant problems. There is the daily dose of abuse, neglect, addictions and violence. It is not hard to become overwhelmed with the repeated stories of tragedy. Case loads, when high, also make it challenging to get out from under.

Workers faced with this, have a natural tendency to see deficits as the story of the client or the family. Further, the majority of assessments tend to emphasize those issues. Many of the mental health and psychometric tools are largely focused on the deficit or identification of problems. Mental health practitioners look for diagnostic clues which can skew their perspective to a symptom based analysis.

I have become interested in the notion of resiliency in child protection as a way to shift not only our view of the client but also the nature of the relationship that we have with them. There is research that tells us that the relationship is the most powerful tool that we have in our work. I am reminded of the work of Maiter, Palmer & Manji which notes:

Parents appreciated workers who were caring, genuine, empathetic, exceptionally helpful, non-judgmental, and accepting. Negative qualities of workers identified by parents were being judgmental, cold and uncaring, poor listeners, critical, and insincere.(from the abstract, 2006)

To gain trust and be effective, we also need to have patience and begin to understand the ecological reality of the client - including their strengths. What got me thinking about that is a TedTalk by Dr. Gabor Mate speaking about addiction. He suggests that we ask the question "What is right about it?" Imagine asking that question with our clients. We begin then to explore the value of what the client has been doing even when we can easily see it as harmful. 

The power of the relationship can also be seen in a Canadian study in 2012 by Gladstone et el.:

 A relationship was found between workers' perception of parent engagement and parents' perception of their own engagement, as well as between the perceptions that workers and parents had around their own respective engagement. Workers who were satisfied with service outcomes were significantly more engaged than those who were unsatisfied. Parents thinking that their children were safer as a result of intervention were significantly more engaged than parents who thought that their children were less safe. The strongest reason given by parents for positive change was being able to trust their worker (p < .001) and believing that their worker was knowledgeable about parenting (p < .01). (again from the abstract)

I reflected further on this when working with a client recently who has a substance abuse problem, mental health issues and self harming behaviours. It is quite easy to get focused on the problems. But when I went to Mate's question, I began to see how she had survived and coped with a long list of traumas in her life. Her support system had collapsed and her internal resources were overwhelmed. She had found a way to exist. Reframing the behaviours in this way changes how she is seen but most importantly, how she reacts to the relationship.

One of the barriers to change can be what we believe is possible. If we do not see that it can be done, then it takes a strong client to prove us wrong. Not to be mistaken, there are clearly situations where clients resist change or it is just too much for them.

There are also now indicators that, just as trauma can pass between generations through DNA (e.g think of the study of epigenetics) there is also data that suggests that recovery, resilience and strength can pass as well. For an interesting brief read on this, you might look at Dr. Laura Kerr's blog. 

There is also research out of the United Kingdom suggesting that it is worth looking at the child's well-being. The Children's Society has recently published the 2015 Report, The Good Childhood. I like this report as it invites us into a broader and richer view of seeing how a child is doing. The report starts by noting:

Though it is easy to slip into a shorthand of happiness, well-being is about so much more than this. It is about how young people feel about their lives as a whole, how they feel about their relationships, the amount of choice that they have in their lives, and their future. Wellbeing matters as an end in itself, but also because it is correlated with other outcomes in life such as physical and mental health...

In essence, what this all begins to tell us that there are very good reasons to be hopeful in many of the cases we work with - not all - but many. It is also worth remembering that our goal is not perfection but good enough (Choate & Engstrom, 2014).

References:

Choate, P.W. & Engstrom , S. (2014) The “Good Enough” Parent: Implications for Child Protection, Child Care in Practice, 20:4, 368-382, http://dx.doi.org.10.1080/13575279.2014.915794

Gladston, J., Dumbrill, G., Leslie, B., Koster, A., Young, M. & Ismalia, A. (2013). Looking at engagement and outcome from the perspectives of child protection workers and parents. Children and Youth Services Review, 34 (1), 112-118. doi:10.1016/j.childyouth.2011.09.003

Maiter, S., Palmer, S. & Manj, S. (2006). Strengthening social worker-client relationships in child protective services: Addressing power imbalances and 'ruptured' relationships. Qualitative Social Work, 5(2), 161-186. doi: 10.1177/1473325006064255

Pople, L. The Children's Society, Rees, G., Main, G. & Bradshaw, J.. (2015). The Good Childhood Report 2015. London: The Children's Society. 

Dissenting opinions really matter

Imagine being in a case conference and not feeling that the assembled group has considered all of the needed information. Imagine as well, that you are a junior in the room. What typically happens, is that the junior will keep quiet. They may try to explain their concerns to a trusted colleague later but their ideas are lost to the group.

The aviation industry has considered this problem as contributing to airline accidents. They have been working at creating an environment where all in the cockpit feel comfortable speaking up. The risks for a plane are a bit more obvious - if the error occurs it might crash killing many. But it is in the analysis of prior accidents that it has become clear that speaking up can save lives.

Professor Eileen Munro of the London School of Economics has pointed out in earlier writing that we should learn from other industries who have taken time to dissect how to prevent disaster. She believes that there are lessons to be learned. I agree.

For too long, however, we have relied upon the courage of a dissenting member of the group to speak up rather than encourage dissenting opinions. When that occurs, we tend to see group think - this is where the group coalesces around the opinion of the majority. In particular, the group tends to conform to the opinions of the more powerful members. This leads to errors in thinking and decision making because it assumes that the powerful member or the group has it right.

The group may, however, in seeking consensus, also filter out data that contradicts the group or power member opinions. Thus, they become selective in what data they consider rejecting data that strays from the group opinion. It leads to conformational thinking as opposed to critical thinking.

Serious case reviews and similar reviews of death and injury in child protection cases has identified this concern.

The minority opinion can often contain insights or perspectives that have not been given much consideration or analysis. These opinions can open up new perspectives or link previously unlinked data. They can also act as a way to ensure various options are considered.

It shouldn't take courage. Rather, it should be encouraged. The group leader should seek the conflicting opinions. The challenge is that it takes time - typically in short supply in high demand, high caseload environments. Yet failing to do so places people at risk.

For the minority opinion holder, there is also the use of language. Certain terms and words catch the group's attention more than others. Indicating that you have serious concerns, serious reservations, you are quite uncomfortable with the direction being taken, you think that the plan is unsafe,  are all terms that can garner the group's attention. How we say it matters as much as what we say.

By encouraging this approach, we can reduce harm to children and families.  In a previous blog I spoke about the B.C. Supreme  Court decision that held social workers liable for their decisions to place children in the care of an abusive father. The judge's decision illustrates that contradictory data did exist. This might be an example of how group think occurred and dissenting opinions were either squashed or not voiced. There are many other examples.

But it is up to managing leaders to create an environment where various points of view are welcomed. When a dissenting opinion occurs, how can it be seen as needed and explored? Management can act in a way that sees the opinion as needed or do the opposite. Thus, the quality of the supervisory environment serves to encourage or discourage the voicing of minority ideas. Otherwise, it can be very lonely to be the "other voice".