Presentation on theme: "Strengthening Family Relationships"— Presentation transcript:
1Strengthening Family Relationships Welcome to Session 5!Strengthening Family Relationships
2Remember the Core Competencies of PRIDE: Protecting and Nurturing ChildrenMeeting Children’s Developmental Needs and Addressing Developmental DelaysSupporting Relationships Between Children and Their FamiliesConnecting Children to Safe, Nurturing Relationships Intended to Last a LifetimeWorking as a Member of a Professional Team
3Supplemental Handouts for This Session Copy of Ecomap Diagram Exercise for your homeworkResources to bolster your community support:List of Medicaid HMOsList of WIC Office Locations
4What is the connection between family relationships and a child’s self-esteem? How children feel about themselves is related to their sense of family and belongingHow children feel about themselves is related to the respect and dignity they feel about their cultural and ethnic affiliation
5Why Are Children In Foster Care At Risk Regarding Developing Positive Self-esteem and Personal and Cultural Identity?Children may feel they are responsible for bad things happening to them because they are not loveable or valuableCultural identity can be negatively affected if placed out of their own culture and heritageFoster parents cannot provide children with a legal status, social status, continuity of parenting and commitment that comes from being with one’s own family
6Your role as a resource family is to ensure that the children in your care have the opportunity to develop to their fullest potential!
7The Bluest Eye by Toni Morrison “Each night, without fail, she prayed for blue eyes. Fervently, for a year she had prayed. Although somewhat discouraged, she was not without hope. To have something as wonderful as that happen would take a long time.Thrown, in this way, into the binding conviction that only a miracle could relieve her, she would never know her beauty. She would see only what there was to see: the eyes of other people.”
8Can You Help Me Know Who I Am? Much of the way in which our identity forms has to do with how others see us, react to us and provide feedback to us. We tend to pick up cues about who we are from other people.We begin to form our sense of who we are from the messages we receive from those who surround us.
9Cultural vs. Racial Identity Cultural identity is a part of every child’s development. Race is only one aspect of a child’s cultural identity.Through cultural identity, children develop values, life routines, communication patterns and religious beliefs, as well as a taste for certain foods and a knowledge of how life is celebrated and honored.Children of the same race may still have differences in their cultural identity.
10Development of Racial Identity Racial identity may challenge resource families when working with childrenWe ask ourselves, “When do children begin to notice that skin colors differ?”PRIDEBook Page 163 describes one model of how racial identity develops
11Development of Racial Identity From birth to age 3, toddlers become aware of physical race and skin color difference and learn names for specific groups. They do not comprehend the real meanings of these labels.
12Development of Racial Identity With young toddlers, how would you promote a sense of positive racial identity?Have dolls, toys and books that reflect the child’s racial and cultural identityEnsure that children learn appropriate names for specific groupsAcknowledge differences in skin colors if the child asks or seems to noticeAvoid long explanations- indicate acceptance of differences through smiles, physical gestures and positive comments.
13Development of Racial Identity From ages 4 to 6, preschoolers can usually identify their own racial or ethnic group and may place a positive or negative value on their own and other groups.
14Development of Racial Identity With preschoolers, how would you promote a sense of positive racial identity?Continue to have dolls, toys and books that reflect the child’s racial and cultural identityModel positive feelings about the cultural affiliationsClosely monitor television and other media to ensure that the child is receiving positive messages about his/ her identityEnsure that the child sees other people who look like him/ herAcknowledge differences in a positive way and encourage the child to begin to talk about how he or she views differences
15Development of Racial Identity From ages 7 to 11, children usually have a firmer understanding of their own racial and ethnic identity and- given the opportunity- will explore what it means to be a member of this group.
16Development of Racial Identity With children of this age, how would you promote a sense of positive racial identity?Continue to have dolls, toys and books that reflect the child’s racial and cultural identityBe prepared to talk honestly about the differences and how the child experiences the differencesHelp the child to find a positive role model who reflects the child’s racial identity and is willing to spend time with the childGet the child involved in organizations and groups with a cultural focusParticipate in activities that support the child’s cultural identity (cook special foods together, attend festivals, parades or events that promote the child’s culture)
17Development of Racial Identity From the ages 12 to 18, adolescents do a lot of exploration related to identity including determining the significance of race, ethnicity, culture, adoption and examining how these apply to the individual.
18Development of Racial Identity With teenagers, how would you promote a sense of positive racial identity?Many teens will enjoy some of the activities discussed for latency age children- festivals, groups, music, etc.They may adopt traditional dress and hair styles and seek to become immersed in the cultureThere is a critical need to talk honestly and deal with the concerns that teens presentDo not become defensive and try to refrain from minimizing or denying racial and cultural concerns
19Challenges of Cultural and Racial Identity What are some of the challenges you may face regarding a child’s cultural or racial identity?School projects that involve family historyOther children may make cruel or inappropriate commentsChildren may feel embarrassed that they look different than your familyLack of historical photos/videos of the child’s lifeLack of historical photos/videos of the child’s family
20How Do You Respond to Racial Bias? I can go shopping alone most of the time, fairly well assured that I will not be followed or harassed by store detectives.I can turn on the television or open to the front page of the newspaper and see people of my race widely and positively represented.I can go into a bookshop and count on finding the writing of my race represented; into a supermarket and find the staple foods that fit with my cultural traditions; into a hairdresser’s shop and find someone who can deal with my hair style.I can do well in a challenging situation without being called a credit to my race.
21How Do You Respond to Racial Bias? I am never asked to speak for all the people of my racial group.I can be reasonably sure that if I ask to talk to “the person in charge,” I will be facing a person of my race.I can easily buy posters, postcards, picture books, greeting cards, dolls, toys and children’s magazines featuring people of my race.If a traffic cop pulls me over, I can be sure that I wasn’t singled out because of my race.I can choose blemish cover or bandages in “flesh” color and have them more or less match my skin.
22Situations You May Experience Your family has known the Smiths for years and you consider them to be good friends. The children in your families grew up together. They played often, participated in activities together and were close friends. Your minority son is now 16 years old, as is the Smith's oldest daughter. Your son asks their daughter to go to the prom with him as his date. She tells your son she can't go with him because he is not white. Your son comes to you questioning why he could be her friend all these years but can't take her to the prom.What would you tell your son?As a parent, how would you feel?How would this affect your relationship with the Smiths?
23Situations You May Experience Your adopted daughter, Tina, who is twelve years old and of mixed race, comes home from school visibly upset. When questioned, she begins to cry and tells you that her friend, Joyce, told her that the Bible says it's a "sin" to mix the races. She was also told that Joyce's mother said that, not only is your family a sin, but because Tina is mixed race, her birth was a sin. Tina loves to go to church and religion is becoming important to her. She is very troubled about what Joyce told her and wants to know if this is true.What is your initial reaction?What will you tell Tina?Will you approach Joyce’s mother?
24Situations You May Experience You are grocery shopping with your 6-year-old adopted daughter, who is of a minority race. A woman approaches you in the aisle, smiles at you and asks, "Is your child adopted?" You reply that she is. She comments, "What a wonderful person you are! God will certainly reward you in heaven. What a lucky little girl she is!"How would you feel?How would you respond to the woman?What concerns might you have about the way that your child might interpret the woman’s comments?
25Challenges of Cultural and Racial Identity What kinds of things can you do as a family to help deal with some of these challenges?Immerse yourself in school projects with your child – it will be an educational experience for you as wellReassure your child that the hurtful comments of their peers are probably because they don’t understandParticipate in foster/adoptive family association functions – children see other similar familiesTake as many pictures/videos of the child as you can – include their photos with your family’s
26Multiethnic Placement Act of 1994 (MEPA) Federal law enacted as part of the Improving America's Schools ActDesigned to:Decrease the time children wait for adoptionPrevent discrimination in the placement of childrenFacilitate the identification and recruitment of foster and adoptive families that can meet children's needs
27Multiethnic Placement Act of 1994 (MEPA) Prohibits foster care and adoption agencies from delaying or denying or otherwise discriminating in making a placement decision on the basis of race, color or national originProhibits agencies and entities from categorically denying the opportunity for any person to become an adoptive or foster parent solely on the basis of the race, color, or national origin of the adoptive or foster parent or the childRequires states to develop plans for the diligent recruitment of potential foster and adoptive families that reflect the ethnic and racial diversity of children in the state for whom foster and adoptive homes are needed
28In What Ways Can You Work With the Team to Support Family Relationships? Support family visitsTalk positively to children about birth familiesEncourage birth parents’ participation in decision making for the childObtain pictures of the birth familyTake the child back to visit community/church/schoolPlan for telephone calls or lettersHave the child draw pictures/artwork for birth familyInclude birth family in child’s prayers at bedtime
29In What Ways Can You Work With the Team to Support Family Relationships? Ensure that items given to the child by their birth family are respectedReassure the child that the birth family cares for him/her despite the difficulties the family has had in meeting child’s needsBe courteous and respectful to the birth family in front of the childHelp birth family cope with their lossesDo not talk negatively about birth family in front of or to the childAsk for birth parents’ input or assistance on a parenting issue
30Foster care is a support for families Bridging the GapRemember …Foster care is a support for familiesYour role is to ensure that the children in your care have the opportunity to develop to their fullest potential
31The Ecomap DiagramThe Ecomap diagram, along with the Genogram that we discussed in Session 2, are tools that can help us understand our family relationships, and how these relationships contribute to our self-esteem, personal identity and cultural identity.
33Ecomap Diagram – The Basics Members of my family include _______.Important friends of our family include _______.The network to meet my family’s developmental needs includes _______.My family’s employment and income is met through __________.The teams and voluntary networks in which my family is involved include ________.Changes or transitions in my life, some of which are positive and some negative include ______.
34Ecomap DiagramAs an example of an Ecomap, either use Bud’s Ecomap or the Hanson Family Ecomap from the PRIDEBook (redundant to use both). Both sets of slides are included here. Just omit the exercise that isn’t used.
37The Hanson Family Ecomap PRIDEBook Pages show the Hanson Family ecomap both before they became resource parents and after.What are some of the most notable changes you can identify?
38The Hanson Family Ecomap The “after” ecomap is much more complicated and involved.There are many more people and agencies that were added.There are new relationships with birth families.Other resource families appear to be the friends in the support network.The strength of some connections had to decrease in order to make room for all of the new connections (like Emma no longer working outside the home).Some of the connections have become stressful (like Carlton’s union) because the family has less free time.
39Please complete your family’s Ecomap Diagram as homework. Changes andTransitionsDevelopmentalNeedsNetworkFriends-+Please complete your family’s Ecomap Diagram as homework.Your Family CircleFamilyEmployment/IncomeTeams/Voluntary Networks
40The Child Health Program Partnership between the UMDNJ School of Nursing (Francois-Xavier Bagnoud Center) and DCF/DYFS, established in 2008The purpose of the Child Health Program (CHP) is to support DCF/DYFS to ensure that the medical/dental/mental health needs of children in out-of-home placement are metThe CHP develops child-specific health care plansThe CHP adheres to recommendations of the American Academy of Pediatrics (AAP)
41The Child Health Program “Health Care Management is the responsibility the of the child welfare agency, but it is a function that requires medical expertise.” 1Numerous studies indicate that children and adolescents in foster care have multiple physical, emotional and developmental needsHealth Care Management is provided by the CHP to overcome barriers to ensure that children & adolescents receive high-quality, comprehensive and coordinated health care1 Fostering Health: 2nd Edition, Task Force on Health Care for Children in Foster Care, AAP, 2005
42The Child Health Program Responsible for managing the health care needs of children in out-of-home placement through Health Care Case ManagementOngoing interaction with DYFS staff regarding health and medical needs of children in placementProvide nursing summary and Individualized Health Care Plan for children
43Components of Health Care Services The American Academy of Pediatrics indicates there are four primary components to health care services:An initial health screening (pre-placement exam) within 24 hours of placementA comprehensive medical and dental assessment (CHEC or CME) within 30 days of placementA developmental and mental health evaluation (part of CHEC)Ongoing primary care and monitoring with the child’s Medical HomeContinuity of care for children in out-of-home placement is paramount!
44Initial Health Screening Pre-placement or re-placement physicals are completed within 24 hours of placement/re-placementPhysicals are to be completed by CHU nurse, Urgent Care Center or Medical HomeDYFS policy prohibits pre-placement and re-placement physicals in hospital emergency rooms unless deemed necessary by the Local Office Manager
45Comprehensive Medical Exam Comprehensive Health Examination for Children (CHEC) includes a mental health assessment (detailed interview and evaluation)Comprehensive Medical Examination (CME) includes a mental health screening (just a few general questions)CHU Staff Assistant will coordinate and schedule – must be completed within 30 days of placement
46Developmental & Mental Health Evaluation If during CHEC/CME needs are identified, CHU will follow up to assure that appropriate follow-up is obtainedChildren under age 3 should have an evaluation by the Early Intervention Program (EIP)
47Ongoing Primary Care and Monitoring with Medical Home Medical Home refers to child’s primary care physicianMedicaid HMO must be selectedContinue with prior Medical Home when feasible (continuity of care)Early Periodic Screening, Diagnosis and Treatment (EPSDT) exams at specified intervals as per Bright Futures/AAPImmunizations per Centers for Disease Control (CDC)Routine dental exam and care every 6 months, starting at age 3*.
48How It Works: The Child Health Unit Group of child health care staff (nurses and assistants), dedicated to serving DYFS children in a given area:Ensure that children receive their immunizations, dental and medical appointments according to the American Academy of Pediatrics and Bright FuturesTMAccess immunizations recordsObtain medical records and medical informationAssist Resource Parents with advocating for a child’s health care needsManage the health care needs of children in out of home placement
49How It Works: The Child Health Unit Group of child health care staff (nurses and assistants), dedicated to serving DYFS children in a given area:Health care resources, support, and education for Resource FamiliesA “bridge” to the healthcare communityCommunicates with those involved in care of child, keeping them informed of child’s health status and participating in key case conferences concerning the childMay attend regional placement conferences, family team meetings, court hearings, etc.
50Ensuring That A Child’s Health Care Needs Are Met The Child Health UnitEnsuring That A Child’s Health Care Needs Are MetPhysical Health NeedsChildren receive Early and Periodic Screening Diagnostic and Treatment (EPSDT) examinations in accordance with the periodicity scheduleChildren receive timely immunizationsChildren receive appropriate follow-up care to address their health needs (includes follow-up of the recommendations of health care providers)
51Ensuring That A Child’s Health Care Needs Are Met The Child Health UnitEnsuring That A Child’s Health Care Needs Are MetMental Health NeedsChildren receive mental health assessmentsChild Health Unit will work with DYFS to ensure referrals that service are in placeDental Health NeedsChildren 3 years and older receive semi-annual dental examinations- unless indicated otherwise. New recommendations began screening at age 1.
52The Child Health Unit Communication is KEY! In-Person Contact: The Child Health Nurse will contact Resource Parents and make a home visit within 2-3 weeks of placement and visit about every 2-4 months depending on the child’s healthcare needs.Phone Contact:Resource Parents are expected to contact their child health nurse to inform them of any changes in health care status of the children in their care, doctor visits, new medications, etc.
53The Child Health Unit In the Beginning … Ensure pre-placement and re-placement physicals for children in placement are completed within 24 hours of initial placement or a change in placement.The child health nurse will complete a DYFS form that is the child’s Health Passport. This is mailed or given to the Resource Parent.The nurse may be calling you to discuss significant health care issues before receipt of the Health Passport.
54The Child Health Unit Ongoing care… A child health care plan is developed by the Child Health Nurse which will include their nursing plan and recommendations from health care providers and other community sources as well (e.g. School).The Health Care Plan is a living document and so it changes as the health care of your child changes. The Child Health Unit staff and Resource Parents will be communicating often.
55Child Health: YOUR Responsibilities Maintenance of a “Medical Log” by the Resource Parent is expected and will be reviewed by the nurse at visits. The Medical Log should include all health care visits (well & sick), medications, illnesses, injuries, appetite.According to DYFS policy, if a child has a fever of 100.4°F, you must contact your child’s primary doctor.The Resource Parent must maintain a copy of the child’s immunization record.Psychotropic medications require DYFS approvalCPR Certification is recommended for all Resource Parents and caregivers.
57How Visits Support Family Connections The most significant way in which family connections are supported is through family visits.Research has consistently shown that visits are the key to reunifying families, because the relationship and bond are maintained!
58Goals for Family Visits Different members of the team may have different goals for the visit:The child needs to know he or she is loved and lovable and that parents are all rightThe birth family needs to know that the child is being well cared for and that the child has not forgotten themThe resource family needs to understand the family relationships/dynamics in order to support the child in his or her attempt to understand the birth family and their situationThe Caseworker needs to provide direct input into the parent-child relationship, observe parenting skills and obtain data to make decisions
59Common Concerns About Family Visits and How They Are Addressed Resource parents may think that the birth parents might try to harm or kidnap the children.Contact is typically supervised and parents have guidelines to follow.Resource parents may be afraid that birth parents will find out where they live and create a disturbance.Parents are not informed of the child’s location unless it is authorized by the resource family to do so.Resource parents believe that parents who have abused/neglected their children don’t deserve to see them.Parents have a legal right to see their children unless rights have been terminated. Visits are mandated.Experience shows that sibling ties are very strong, even with rivalry. Siblings may need each other more when parents are not available.Resource parents may observe that the children are happier not to see their siblings because of sibling rivalry.The team should assess which kin contacts are important to maintain.Resource parents may observe that the children do not enjoy visiting with their relatives.Adoptive parents may be afraid that it could slow down the process of attachment to their family.Attachment is a complicated process. It is possible to build attachments to different people at the same time.
60More on VisitsPRIDEBook Pages provide information about how to prepare for visits and what to expect about their location, frequency and lengthNOTE: DYFS policy mandates that the birth family be provided with a visit within 5 working days of placement.
61What are some things that a child needs in order to be well prepared for a visit? A clear understanding of the visiting arrangementsAs much information as possible about the visit ahead of timeTo be prepared for the parent’s reactionTo be prepared for his/her feelings and reactionsTo understand that emotions are complicated and unpredictable, and that the visit may bring up a range of these feelings
62In what ways can we help children at the end of a visit or after a visit? After saying goodbye, remove the child as quickly and as calmly as possible from the visiting locationLet the child know that you are there to listen, but do not question them about the visitTell the child when the next visit will beMake a statement that allows the child to know that he or she can express feelingsAfter visits, be prepared to pick up the child’s cues – some children want to be left alone, others need to be with someone, many children need to sleepDon’t force the child to eat or push them to be affectionate
63Promoting Family Continuity Think about how a lack of family history might be a problem for someone …Unable to answer medical history questionsUnable to give mother’s name for identificationUnable to tell children about their ancestorsMay cause someone to experience a grieving reaction or trigger an identity crisisLack of family history can be an issue for children in foster care or who are adopted
64Bridging the Gap Other Foster Family Foster Family Adoptive Kinship (group home,residential,hospital)FosterFamilyFosterFamilyKinshipFamilyAdoptiveFamilyBirthFamily
65Tasks or Activities to Bridge the Gap The families can meet and get to know one another, plan for transition, and share informationThere should be pre-placement visits for adoptionFamilies can maintain contact after the child is placed or movedShare pictures and lettersTalk to the child about the transition
66LifebooksA Lifebook is a tool that can be used to build a sense of history and continuityIt is a child’s record of families and connections, both past and presentA Lifebook can be a photo album, a loose-leaf binder, folder or composition book, a scrapbook, or even a videoThe collection should include information about why the child came into care, pictures of where he/she has been, names of significant people and important life eventsContributions to Lifebooks can be from you, the child, the birth family, the caseworker or any other person in the child’s lifeMaintaining a Lifebook is a DYFS licensing requirement.
67CLOSURE Review Key Points, PRIDEBook Pages 183-188 Review You Need to Know!, PRIDEBook PagesRead Birth Parent’s Perspective, PRIDEBook Page 193Complete the PRIDE Connection exercise on PRIDEBook Pages (copy in packet)Read Making A Difference!, PRIDEBook PageSession 6: Meeting Developmental Needs: Discipline
68Supporting Family Connections and Continuity Will’s World PRIDEBook Page 152 tells the story of Will as he enters foster careWhat connections are at risk for Will?
69Supporting Family Connections and Continuity Will’s World His family (mother, grandmother, uncle)His friends (Jim, other neighbors, couple upstairs)His mother’s former boyfriendHis teachers and school (gym teacher)His school counselorLittle LeagueThe neighborhood health clinic
70How Can The Team Work to Maintain These Connections for Will? Support regular visits with his motherSupport regular visits with his grandmotherExplain to him that his uncle is sickAllow him to continue playing on his little league teamEncourage him to write letters to his family, friends, teachers, etc.Continue his health care at the neighborhood clinicAllow him opportunity to say good-bye to his teachers and school adjustment counselorEnsure that he is connected to a new school adjustment counselorProvide him with as much information as possible about his new family, school and communityDiscuss his history with him so that he will be more able to understand how his foster family fits within his life
71What message are we sending to Will when we work to maintain these connections? We demonstrate unconditional acceptance of who he isWe show respect for his personal connectionsWe help him to be more self-acceptingWe bolster his self-esteem and assure him that his circumstances are not his fault
72What message would we be sending to Will if we did not support these connections? We would send a message that there is something bad about himWe would be rejecting his family, friends and community, and therefore be rejecting himHe would learn that he cannot trust his new caregivers, who have already failed to meet his needs for connection and belonging
73What Would You Do If … ? Four video vignettes: Norma, age 15 − Michele, age 9Mike, age 5 − Charlie, age 10For each vignette, think about these questions:Why might the child behave this way or feel this way?How can you handle the immediate situation?What long-term tasks might you identify for the foster care team?
74Preparing Annie for a Visit As you watch the video think about the following…What concerns does Annie seem to have as she approaches the visit with her mother?In what ways does the resource parent address these concerns and/or help to prepare Annie for the visit?
76Annie’s Visit Experience Think about the goals we talked about for the different members of the team. In what ways were some of these goals accomplished during the visit?For Annie?For her mother?For the resource family?For the caseworker?
78The mother was late for the visit What were some of the issues or challenges that came up during the course of the visit?The mother was late for the visitThe mother seemed to be questioning Annie’s careThe mother was unable to support Annie’s efforts in school
79Annie’s Reaction to the Visit As you watch this last video clip, consider the following:Why do you think Annie is behaving this way?What strategies might you use to help Annie with her behaviors?How might you feel about handling a child’s behavior after a visit?