The following describes a case study scenario in which I am an experienced, protective services worker going to do the first home visit with a new family. It goes on to take a position what might happen, the families reactions, cultural variations and engagement tools and recommendations.
While many service bureaucracies give attention to a single family member as your client or patient, my site visits suggested that the needs of children in particular (and probably other family as well) may be impossible to resolve, as well as perhaps even to diagnose, in case a program's focus is on the average person child as opposed to the family. Actually, programs might need to learn a great deal about the family all together if they are to diagnose and solve the problems of children. At the easiest level, a good example is a difficulty for your baby that is caused by interaction between a teenager mother and her own mother, the baby's grandmother: [One caseworker:] "Most of the grandparents will tell them, "Don't hold the baby, you're going to spoil it. ". . . I spend a lot of time trying to talk to grandparents. " [Another caseworker:] "[You] have to return to the grandparents. These kids [the teens] -- all they hear is 'You're stupid. I didn't get it done doing this. ' So after a while they figure, 'If I touch this baby, it's wrong. ' So, 'Here, momma, take it' (Jones, 2004).
Two examples are shown below, to illustrate more fully how children's needs are nested in a family group context and intimately linked with the parents' and other family members' own private well-being. The first example comes from Oklahoma's Integrated Family Services (IFS) System, which serves multiproblem families:
A seven-year-old boy came to the attention of any school principal because of both physical and emotional health issues. The boy had long been susceptible to seizures and self-destructive behavior and was just starting to threaten other children. When the main called IFS, he found that IFS had been working with the family because the mother was on AFDC and herself had multiple problems. The IFS worker called a gathering of all of the agencies who had contact with the family to talk about the child's needs. Because of this, the boy was admitted and sent to a diagnostic center for a number of months of testing and treatment; the mother received needed services such as mental health treatment and literacy training; and the Child Protective Services worker changed her mind about the possible outcomes for the truth and figured the mother had the actual to be an satisfactory parent (Huston, 2003).
In this example, the needs of the child turned out to be related to the needs of the mother -- and, perhaps more important for the service delivery system, area of the solution to the child's needs lay in providing services to the mother so that she could help him. According to the IFS case worker, "What the child really [may] need is a mother that can cope" (Herr, et al 1999). In the next example, where meeting a child's needs again depends on an adult's well-being, serving the child depends critically on the service deliverer's relationship with the adult. The illustration originates from a niche site visitor who accompanied an instance manager on a home visit:
The case manager made a home stop by at a (18-year-old) mother who had suffered physical and sexual abuse as a child. During the visit, the truth manager picked up and played with the young woman's 8-month-old child and observed the way the child responded. Then she asked the mother a particular question about her experience with the child: Did she ever feel as though she were "climbing the walls" and simply had to escape the home when the baby was crying? The young woman said yes, and the truth manager asked what she did at such times: Was there anyone she could leave the child with so that she could go on a walk? The teen responded that either she left the baby with her friend downstairs and went for a walk, or she put the child in the crib, closed the door partway, and went into another room. The situation manager seemed content with these responses, and she later told the interviewer that, while she has no reason to suspect any abuse or neglect in cases like this, she realizes that the teen is somewhat unstable and under great stress, so she likes to keep close watch on what is going on (Pelton, 2008).
In this example, the truth manager's key contribution to the child's wellbeing comes through her focus on and friendship with the mother. Only the case manager's strong personal relationship with the teen enabled her to keep a constant eye on the situation while not being perceived by the teenager as intrusive, only the strong relationship permitted her diagnosis that the child was doing fine, in support of the relationship permitted her to provide preventive services by means of low-key advice. These links between a child's needs and the well-being of the family all together reinforce the conclusion that effective family service deliverers need a trusting relationship with the family and an ability to reach out across systems (Crosson, 2010; pg 12). In particular, the links between child and family well-being suggest that serving children in multiproblem families requires that the service deliverer know both child and family well and be able to reach out across the service system to help all family members.
2. ) We shall now discuss the three types of preventions with examples.
Many of the "preventive services" offered by the websites (Wolock, 1984) parenting education and support for parents' ability to nurture their children-occur not through formal services but through the relationship between your family and the case manager. However, many of the sites also provide more formal services, such as organizations, classes, or workshops. For instance, all three of the teen parent programs provide teen support groups that touch on parenting issues and also other issues such as self-esteem, health insurance and nutrition, and family planning. In addition to knowledge about parenting, these programs generally emphasize providing mothers with the warmth and support they are seen to need in order to be warm and supportive, subsequently, to their children. Some of the programs also emphasize the actual practice of new attitudes and skills in getting together with children (Herr, et al 1999). For example, in the TASA Next Step program, teen parent support groups are paired with on-site child care, and the sessions are planned so that mothers meet without their children for the first portion of the visit and with the children for the next.
What exactly can it mean to serve children through this case management relationship? Exactly what does the partnership offer besides referral to specific, functional services like those already discussed? More generally, the family-oriented case managers in the website programs serve children by:
1 Keeping an eye on children themselves and helping families gauge how their children are doing;
2 Providing parents with support and friendship, assistance in increasing important family relationships and in dealing differently with their children, and information about parenting or children;
3 Providing friendship, support, and role models for a child directly; and encouraging other service deliverers to respond better to a child's needs.
In several programs, case managers battle to gather their role with regards to an individual client, like a teen mother or a school age child, with the role with regards to the family all together. In these successful examples, case managers reported integrating those roles to start to see the child in a family group context rather than advocating for one family member against another, however, not all experience were as successful. In addition, case managers operated with quite different degrees of training in child development and family functioning; again, the examples illustrated in this paper show what's possible with training and, in a number of cases, expert backup support.
3. The next discusses the societal changes that should be made to protect children in the twenty-first century.
Children who are growing up in poverty or other varieties of need are likely to come into contact with other large public agencies aside from the welfare system: the public schools, community health clinics or city hospitals, and, perhaps, sadly, the state's child protective services agency. What are the implications of the findings presented here for the other large public agencies that see poor children and families? To put the question slightly differently, what principles would we connect with each system if we wished to generate a coherent network of services to children? While this study was not made to investigate other service systems in any detail, the research sites do suggest several intriguing speculations (Crosson, 2010). First, other agencies aside from the welfare department can and should consider what this means to be two-generational. As the study sites and the evidence of other researchers suggest, family needs are often intertwined, whereas the services offered by lots of the large systems are limited to a single family member (Jones, 2004). A number of program examples from the site visits and other sources illustrate what it means for service providers apart from the welfare department to be two-generational in their focus:
The PACE program in Kentucky, with its combo of adult literacy and preschool education operates within the general public schools. In addition to offering two-generational services to families that are directly enrolled in PACE, the program director sees PACE as a car for changing the thinking about the general public schools toward a greater inclusion of parents and other family members.
Child protective services workers in a number of of the research sites found that dealing with intensive case managers helped them appreciate the demands on parents that managed to get difficult for the latter, subsequently, to respond to the needs of the child. This insight lies behind a variety of family support and family preservation programs now being deployed as part of the child welfare services continuum in several states. The purpose of these programs is to provide services to both parent and child to boost family functioning and enable the child to stay in the house (Wolock, 1984). Visiting nurse programs allow health care providers to see parents and children together and serve the whole family. Maternal and child health clinics with other collocated services also offer the opportunity to meet the needs of several members of the family.
In several locations in New England, Head Start programs are organizing or already operating programs jointly with education and training programs for mothers on welfare. These programs include cooperative projects with vocational high schools and with a community training agency. The ways in which welfare agencies have overcome these barriers may well offer insights to other agencies (Jones, 2004). For instance, welfare agencies at the successful sites have overcome the limitations of these initial mandate by developing a clear and sustainable mission that makes dear why services to children and families are part of the welfare agency's job. In order to expand services, schools, health clinics, and child protective services agencies may similarly need to articulate connections between a short, narrower mission and the broader, family-centered mission that they would like to achieve (Crosson, 2010). Thus, schools may conclude that they can not teach children with out a collaborative relationship with parents, that they cannot teach children without addressing the problems that keep them from being ready to learn, or that they can not teach teen mothers effectively without addressing their roles as parents as well as students. Child protective services agencies may conclude that functions such as improving family stability and averting foster care are more effective over the long run than providing after-the-fact treatment.
4. ) Discuss the main element similarities and the dissimilarities between your residual ramifications of neglect, physical abuse, and sexual abuse. What implications does this knowledge have for future prevention, intervention and treatment efforts?
While both formal and informal services at the sites are geared to protecting against child abuse and neglect, program case managers sometimes find that they need to take stronger, more drastic actions to ensure a child's safety and well-being. Case managers in several the programs ask child protective services employees for informal consultation and help when they are worried in regards to a family, and many said that they had made child protective referrals (hotlined a family) at least once (Pelton, 2008). The informal consultation appears to go both ways: Child protective services personnel in a number of locations reportedly ask the site case managers to monitor families which they worry about but cannot serve themselves, given their caseload of even more urgent crises.
The worker must have the ability to cross professional boundaries to meet a wide variety of family needs. In order to serve the kid, he or she must also develop a relationship with the whole family, since the child's well-being is often intimately bound up with the well-being of other family members. No agency attempting to move around in a two-generational direction should expect the change to be easy (Wolock, 1984). Many of the obstacles experienced by welfare agencies apply just as forcefully to the other large service systems for poor children and families. For example, difficulties of mission plague both schools and child welfare agencies that consider reaching out to parents, in the same way they hamper welfare agencies that consider reaching out to children. In the school setting, teachers, administrators, and elected overseers may worry that a mission of academic excellence will be compromised by too much focus on the multiple needs that children and their families bring in to the classroom. For child welfare agencies, the conflict is even more stark: In an agency whose mission is to protect children, a lot of whom are in urgent danger, how can it be legitimate to pay comparable focus on their parents? Similarly, each system suffers isolation from other service deliverers and insufficient expertise in the multiple problems of families. Each activities its own set of demands on workers and on the organization all together, demands that must definitely be balanced from the needs of families in virtually any successful solution.