The Child Protection System: The Role of Family Preservation, Support, & Kinship Care Zoe Breen Wood Case Western Reserve University zbw@case.edu

Amasaganalu

Introductions Name Agency / position A positive trait that you learned or developed from your family

Goals for Today An Overview of a child protective system Key principles and beliefs Theoretical underpinnings Focus on initial components of a child protection system Identification of Children at Risk Family Preservation Kinship Care

Building A Learning Community Start & end on time Ask questions Share expertise Safe environment Others?

Case Study: The Bahailu Family What are the family’s strengths? What are the family’s needs? What more do you want to know about the family?

Foundations for our discussion Systems theory Ecological perspective Strengths base Maslow’s Hierarchy of Needs Developmental perspective

Systems Theory Whole / parts Movement in one impacts movement in others / all. Boundaries Multifinality Equifinality

Ecological Perspective Person-in-environment

Strengths Base All individuals, families and systems have strengths. Most effective interventions identify and build upon those strengths.

Maslow’s Theory “We each have a hierarchy of needs that ranges from "lower" to "higher." As lower needs are fulfilled there is a tendency for other, higher needs to emerge.” Daniels, 2004

Maslow’s Theory Maslow’s theory maintains that a person does not feel a higher need until the needs of the current level have been satisfied. Maslow's basic needs are as follows:

Basic Human Needs Food Air Water Clothing Sex Physiological Needs

Safety Needs Protection Stability Pain Avoidance Routine/Order Safety and Security Protection Stability Pain Avoidance Routine/Order Safety Needs

Love and Belonging Social Needs Attachment Affection Acceptance Inclusion Social Needs

Esteem Esteem Needs Self-Respect Self-Esteem Respected by Others

Developmental Perspective Types of Development Physical Cognitive Psychological Social Emotional Stages of Development

The Child Protection System Goals Beliefs Model

Goals Safety Permanency Wellbeing

COMMUNITY FAMILY THE CHILD PROTECTION SYSTEM Prevention Identification of Children at Risk Institutional Care Child Family Preservation Intercountry Adoption Reunification Domestic Adoption Kinship Care Foster Care Independent Living GOVERNMENT AGENCIES NGO’s

Guiding Principles Every child has the right to be protected. (Convention on the Rights of the Child) Children do better in families. Children should be in the least restrictive most home-like environment , as close to the child’s own home as possible in which they can be safe. The child welfare system must promote permanence for all children

Guiding Principles Children have a right to remain connected to their family, their community, their culture & their heritage. Solutions to the challenges facing children are best developed within the community with assistance from those outside. The child welfare system must be culturally competent. People can and do change. Change happens in the context of relationships

DISCUSSION Think about the Child Protection Model and Your Agency / Program Where does your program fit?; What level of Maslow’s needs do you meet?

Today’s Focus Identification of Vulnerable Children Family Preservation & Support Kinship Care Tools for Assessment

COMMUNITY FAMILY THE CHILD PROTECTION SYSTEM Prevention Identification of Children at Risk Institutional Care Child Family Preservation Intercountry Adoption Reunification Domestic Adoption Kinship Care Foster Care Independent Living GOVERNMENT AGENCIES NGO’s

Risks to Orphaned, Abandoned and Homeless Children Health Educational failure/lack of achievement Mental Health & Substance Abuse Incarceration/Criminal Involvement

Health Miller and Hendrie (2000) evaluated 452 children (443 girls) adopted from Chinese institutions. The duration of orphanage confinement was inversely proportional to the linear height lag (r = .9), with a loss of 1 month of height age for every 2.86 months in the orphanage. Seventy five percent of the children had a significant developmental delay in at least 1 domain: gross motor in 55%, fine motor in 49%, cognitive in 32%, language in 43%, social-emotional in 28%, activities of daily living in 30%, and global delays in 44%. Overall, elevated lead levels were found in 14%, anemia in 35%, abnormal thyroid function tests in 10%, hepatitis B surface antigen in 6%, hepatitis B surface antibody in 22%, intestinal parasites (usually Giardia) in 9%, and positive skin test results for tuberculosis in 3.5%. PEDIATRICS Vol. 105 No. 6 June 2000, p. e76

Educational Failure Case, Paxson, & Ableidinger in 2004 compared educational outcomes for children in 10 Subsahara (African) countries and found children orphaned due to HIV/AIDS are less likely to be enrolled than are nonorphans with whom they live, even when controlling for poverty. Demography, 2004; 41(3):483-508.

Mental Health Papageorgiou, Frangou-Garunovic, Iordanidou, Yule, Smith, & Vostanis (2000) in a sample of 95 children of 8-13 years, who had experienced war in Bosnia, were assessed with a battery of standardised measures. They children either came from refugee families (44%), meaning they had experienced homelessness, or had suffered significant family loss (a parent had been killed in 28% and the father was injured or absent in 27% of cases). Forty five children (47%) scored within the clinical range of the depression, 28 (23%) on anxiety, and 65 (28%) on a scale measuring PTSD reactions. Imagine the mental health consequences for children without a family. European Child and Adolescent Psychiatry, 9(2):84-90.

Incarceration/Criminal Involvement Huang, Barreda, Mendoza, Guzman and Gilbert in 2004 compared abandoned street children and formerly abandoned street children in La Paz, Bolivia Some findings: higher risk of police abuse (95% versus 38%) Higher engagement in robbery (26% versus 4%) Archives of Disease in Childhood 2004;89:821-826

Social Service Response Must be collaborative Medical Community and social services NGO and public/government services Faith-based community and secular community

Social Service Response There must a continuum of services, focusing on permanency, safety & well-being The continuum must be community and family based It must incorporate our knowledge of child development as well as family and community development

A Permanency Priority: Strengthen & Preserve Families Unless there is compelling evidence otherwise, initial efforts must focus on strengthening and preserving families Abandonment Prevention for infants Abandonment Prevention for children on the streets (children with families, children connected to families and children on their own)

Strengthen & Preserve Families Requires workers who can assess, intervene and advocate on behalf of vulnerable and at-risk families A systemic and ecological framework Focus on strengths as well as problems and deficits Case management Crisis intervention Immediate and long-term response Any solution or intervention has to take account the historical and cultural context of the family being served

Identification of Children at Risk Requires community standards about the level of need which triggers a need for intervention. Determined by communities taking into consideration culture and resources. What level(s) of Maslow’s hierarchy must be met in order for children to be free of risk?

Discussion What are the legal definitions? Are legal definitions needed? What mechanisms/ systems are in place to identify children at risk? Do some components of your system focus more on some categories to the exclusion of others? How well do the identification systems work together? Are there gaps ?

Family Preservation Intervention and supportive services provided to allow the child to remain with his family. These services can address: basic needs, development, mental health, abuse/neglect, trauma, violence, and natural disasters.

Family Preservation target population includes families who are at imminent risk of having a child placed outside the home or have been the subject of an indicated maltreatment report in-home service provision

Family Preservation Crisis oriented and/or long term Case Management Empowerment & strength based

Examples of Family Preservation Programs Emergency referrals Food & economic support Job training Prenatal care Home visits for mothers & young children Health & developmental assessment Parenting classes After school & youth development programs

Discussion What family preservation programs currently exist in your community? What level of Maslow’s hierarchy do they address? How well do these programs coordinate their services / collaborate? What are the gaps? What additional services need to be developed?

Examples of Family Preservation Programs Counseling Child care Mentoring Support groups Family activities Life skills Personal safety, and community awareness

Kinship Care Is family preservation and is a very good permanency option Involves identifying appropriate family members or fictive kin Assessing their willingness and ability to provide safety, permanency & well being to a child. Providing ongoing support.

Phases of Family Intervention Evaluation Implementing Planning Assessment Joining

Joining

Professional conversations and personal conversations: What are the differences?

Personal conversations Often spontaneous Unstructured or semistructured Subject to interruptions Can be terminated abruptly Do not need to reach resolution Can tolerate a range of informalities – humour, touching, provocation, challenge, ignoring etc. Are influenced by diversity – age, language, class, culture, ethnicity, politics, religion Often are not strictly time limited Can often be overheard by others Are much influenced by the nature and history of the the relationship – power differentials, empathy/conflict etc

Professional conversations More formal/constrained in language and style Generally not accompanied by physical contact often structured or semi-structured Time limited Goal directed Power differentials play a major role Agency influenced Context dependent Voluntary or involuntary

Interview VS Conversation Interaction designed to achieve a selected purpose & content is chosen to facilitate achievement of that purpose One person takes responsibility for directing interaction and relationship is nonreciprocal Actions are planned, deliberate, consciously selected; Interview requires attention to the interaction, is formally arranged, & unpleasant feelings & facts are not avoided Concern with interface between clients and their social environment

Working together toward goals

Creating a rapport and establishing a relationship A harmonious working relationship (Barker, 1995) Rapport means “close and sympathetic” Social workers place great value on the quality of the helping relationship (Coulshed, 1991) “The relationship is the communication bridge between people”(Kadushin,1990) Feminists have seen building relationships as central to empowerment and growth (Stone, 1991) Cited in Trevithick (2000)

Features of an effective helping relationship Concern for service user’s self-determination Displaying interest, warmth and trust Respect for individuality Acceptance Empathic understanding Genuineness and authenticity Establishing ground rules regarding confidentiality Adapted from Kadushin (1990)

Discussion Identify things that interfere with a worker’s ability to join with his or her clients. Identify strategies that help to join with the individuals & families with whom you work.

Assessment

Assessment Is the process of gathering information that will support service planning and decision making regarding the safety, permanence and well-being of children and families. Assessments are based on the assumption that for service to be relevant and effective, workers must systematically gather information and continuously evaluate the needs of children and families as well as the ability of family members to use their strengths to address their problems.

Assessment is….. Gathering information and formulating a coherent picture (hypothesis) of the client, their environment and their circumstances The beginning of the working relationship The basis for the rest of our work with the client: goals, interventions and progress Constant ALWAYS includes: 1) problems or concerns as seen by the client, 2) legal mandates, & 3) safety concerns

Assessment is a process Begins immediately when your client walks through the door Changes from moment to moment Is based on both your and your client’s views Influenced by your interviewing skills Involves the process of gathering information from client, reading documents, observing client, engaging collateral sources of information… Is accomplished through EXPLORING

Assessment is a product (e.g., A Written Document) Provides guidelines for organizing information Includes assessment of the problem, person and environment Problem assessment is not always as easy as it seems New problems emerge as work continues Underlying issues not showing on the surface (e.g., Truancy) Written in a clear, concise & relevant manner Is strengths-based Ongoing tool for work together

In the Child Welfare System Assessment Cornerstone of family-centered child welfare practice Can be very simple, can be very complex Must be based on thorough, accurate, relevant and current information

Assessment of Child Maltreatment Psycho-Social Factors Child Characteristics Environmental Factors Family Characteristics Parental Conditions that Impair Parenting

What do you see?

List all the items you observed in the previous slide

Information Processing What do we notice? What happens right in front of us that we don’t notice? What leads us to notice some things over others? What barriers that prevent us from noticing what matters most?

Salience depends on: Strength Repetition Strangeness Movement and change Emotional reaction

Our assessments are ineffective if we: So what’s the point? Our assessments are ineffective if we: Draw conclusions with insufficient or erroneous information Do not have relevant information Speed up the process Don’t know the area being assessed Draw conclusions from only part of the information and allow . . .

Personal Factors that Cloud Assessments: Cultural aspects of the worker or family Bias of previous information Confirmation bias Limited available information

Personal Factors that Cloud Assessments: Emotional condition of the assessor Personal involvement in the situation Environmental conditions

Types of Assessment Safety Risk Family

Safety Assessment Imminent threats to safety “if I walk out of here right now without intervention, will the child be safe?”

Best Practice in Safety Assessment Use open ended questions to build rapport. Talk to them at their level, from their starting place (cognitively and emotionally) Interview the child in a neutral place Talk to everyone in the family as well as others who may have knowledge of the condition Talk to the parents of caregivers Ask consistent questions Get an understanding of the family’s perception of the current situation

Risk Assessment Future focused Risk factors Protective factors Leads to a hypothesis of the likelihood of future harm.

Comprehensive Family Assessment The following are characteristics or problem areas most commonly associated with families in the child welfare system: Problems in accepting responsibility, in the ability to recognize problems, or in motivation to change; Patterns of social interaction, including aggressiveness or passivity, the nature of contact and involvement with others, the presence or absence of social support networks and relationships;

Categories of Parental Assessment Parenting practices (methods of discipline, patterns of supervision, understanding of child development and/or of emotional needs of children); • Background and history of the parents or caregivers, including the history of abuse and neglect; • Problems in access to basic necessities such as income, employment, adequate housing, child care, transportation, and needed services and supports; and

Categories of Parental Assessment Behavior/conditions associated with o Domestic violence o Mental illness o Physical health o Physical, intellectual, and cognitive disabilities o Alcohol and drug use.

Elements of Child and Youth Assessment Physical health and motor skills Intellectual ability and cognitive functioning Academic achievement Emotional and social functioning Vulnerability/ability to communicate or protect themselves Developmental needs Readiness of youth to move toward independence

Elements of Child and Youth Assessment Readiness to live interdependently Ability to care for one’s own physical and mental health needs Self-advocacy skills Future plans for academic achievement Life skills achievement Employment /career development Quality of personal and community connections

Elements of Family Assessment Social network Relationships among family members

Elements of Environmental Assessment Adequacy and safety of housing Access to services Presence / absence of health hazards Exposure to violence

Assessment Tools Genogram Ecomap

Definition GENOGRAM = GENETIC MAP Also known as family tree but has additional features. It visualizes hereditary patterns and psychological factors that punctuate relationships. It can be used to identify repetitive patterns of behavior and to recognize hereditary tendencies. / 13

Drawing the Genogram

The basic skeleton of a genogram

Basic Symbols

Symbols: Marital and other Relationships

Symbols of Multiple Marriages

Generational Relationships

A more complex skeleton

Identifying information Names Nicknames Birth date Marriage dates Divorce dates Separation dates Sibling position (birth order—include siblings who died) Family comparisons Personal characteristics or characterizations Occupations and job histories Illnesses Hobbies and other interests Death date (if appropriate) and cause of death

Three-Generation Genogram Name: Date: Grandparents Great Aunts and Uncles Parents Aunts and Uncles Patient Siblings and Spouse(s) lump Children

Develop A Genogram Your own family OR One of your client’s families

Discussion What can you learn from a genogram? How can you use this tool in your work?

Ecomap: What is it? A paper-and-pencil assessment tool The ecomap is a “snapshot” of the client within their family and social environment at a particular point in time. Used to assess specific needs and plan interventions for a client.

An Eco-map is a graphical representation that shows all of the systems at play in an individual's life. They can also be used to depict the flow of “energy” into and out of a system. Eco-maps are used in individual and family counseling within the helping professions.

Interaction With the Environment Systems theory and/or ecological perspective view of the client’s family life. Reveals the nature of the family’s relationships with the outside environment.

Social Environment

Basic Ecomap Symbols Female Male

Connections to the Environment Connect the environment outside of the family with the family members. Where is energy being directed and what is the nature of that exchange? What is the quality of that exchange?

Interaction With Social Environment Identified Client

Commonly Used Symbols Stressful, conflictual +++++++ relationship Tenuous and/or uncertain relationship - - - - - - - Positive relationship _________ or resource The direction of the giving & receiving exchange or a relationship (also known as energy)

Draw an Ecomap Your own family A client family

Discussion What can you learn from an ecomap? How can you use this tool in your work?

Strengthen communities to promote permanency and child well-being Families can only be a strong as the communities in which they live We need to understand community values, needs and problems We need to raise community consciousness about the problems being experience by their families We need community workers who can promote social and economic development for vulnerable and at-risk communities Micro-enterprise & job development Neighborhood and housing development Any solution or intervention has to take account the historical and cultural context of the community being served

Move away for linear planning models Move towards concurrent planning for children rather than linear models of planning for children

The Social Service Response Needs to be both reactive and pro-active It is about programs but also about social policy It is about services but it is also about advocacy

Application to Practice