The rhetoric vs. the reality in child care and protection: ideology and practice in working with fathers

[Trauma, Psychological Stress and Family Situation of Fathers who Experienced Child and Youth Welfare Services: Implications for Youth Welfare Interventions and Therapy]

Trauma, Psychological Stress and Family Situation of Fathers who Experienced Child and Youth Welfare Services: Implications for Youth Welfare Interventions and Therapy This paper explores the current family situation and psychological stress of fathers who experienced trauma and different kinds of youth welfare services including out-of-home placement during their childhood. The main group consisted of n = 119 fathers and was compared to a group of n = 36 fathers whose families never received services from the child and youth welfare authority. In the main group, a high correlation was found between trauma and current psychological stress, albeit the out-of-home care intervention or intensive home-support by child and youth welfare services during childhood. The higher stress level in the main group of fathers in contrast to the comparison group effects their current family situation, especially concerning the contact between fathers and their children. Fathers with higher stress levels were less likely to be in contact with their children. Acting on the assumption that fathers are important for their children, the results implicate a heightened focus on earlier trauma-informed interventions in families with difficulties and out-of-home care settings, to reduce stress levels and prevent intergenerational transmission of problematic family experiences. Current child and youth welfare services, in particular out-of-home placements, should take these trauma-informed approaches and therapy into account.

Análise das contingências presentes na orientação de pais na clínica analítico-comportamental infantil

Buscando compreender a orientação de pais a partir de fatores descritos pela literatura como influentes no processo de generalização (Ocorrência de Orientação, Dinâmica familiar e Regras Funcionais), Os participantes foram 38 pais de crianças atendidas em consulta de Psicólogos com orientação Analitico-Comportamentais. No que se refere ao material, utilizou-se um inquérito por questionário, o Questionário de Compreensão do Processo de Orientação de Pais (Brito & Costa, s/d). Os resultados constataram correlações positivas e significativas entre o processo de generalização e as categorias estudadas, indicando que o psicólogo precisa avaliar e intervir nestas variáveis para melhores efeitos terapeuticos.

When Is Neglect, Neglect?: It Depends on Who You Ask

In order to identify victims of child neglect, social service workers rely heavily on referrals from concerned friends, neighbors, and others in the community. Little is known, however, about how lay individuals perceive child neglect and what factors influence their decision to make a referral. This study explored the effects of child, parent, and participant gender on laypersons' evaluations of child neglect. Participants read a case of neglect of a child by a custodial and absent parent and then rated the parents' culpability and intentionality and decided whether the parents' behavior met the legal definition of neglect. When evaluating the custodial parent, men but not women viewed fathers as more culpable than mothers for the neglect of their son and viewed mothers as somewhat more culpable for the neglect of their daughter. Men also perceived absent mothers as more intentionally harmful than absent fathers. Finally, both men and women were more likely to qualify parental behavior as legally neglectful when the genders of the custodial parent and child matched. Results, which suggest that gender bias may exist in laypersons' perceptions of child neglect and may influence their decisions to report, have implications for identification of and intervention for vulnerable children and families.

Evaluation of a brief intervention to assist health visitors and community practitioners to engage with fathers as part of the healthy child initiative

Aims

To improve engagement of Health Visitors and Community Practitioners delivering the Healthy Child Programme with fathers. To evaluate a one-day, father-focused workshop with a supporting handbook for Practitioners. To identify institutional and organisational barriers to engagement with fathers.

Background

The UK government policy encourages health professionals to engage with fathers. This derives from robust evidence that fathers’ early involvement with their children impacts positively on emotional, behavioural and educational development. Yet, there is little evidence that the importance of engaging fathers is reflected in Health Visitor training or that primary-care services are wholly embracing father-inclusive practice. The Fatherhood Institute (FI), a UK charity, has developed a workshop for Practitioners delivering the Healthy Child Programme.

Method

A ‘before and after’ evaluation study, comprising a survey followed by telephone interviews, evaluated the impact of the FI workshop on Health Visitors’ and Community Practitioners’ knowledge, attitudes and behaviour in practice. A total of 134 Health Visitors and Community Practitioners from eight NHS Trusts in England attended the workshop from November 2011 to January 2014 at 12 sites. A specially constructed survey, incorporating a validated questionnaire, was administered before the workshop, immediately afterwards and three months later. Telephone interviews further explored participants’ responses.

Findings

Analysis of the questionnaire data showed that the workshop and handbook improved participants’ knowledge, attitudes and behaviour in practice. This was sustained over a three-month period. In telephone interviews, most participants said that the workshop had raised their awareness of engaging fathers and offered them helpful strategies. However, they also spoke of barriers to engagement with fathers. NHS Trusts need to review the training and education of Health Visitors and Community Practitioners and take a more strategic approach towards father-inclusive practice and extend services to meet the needs of fathers.

A national study of male involvement among families in contact with the child welfare system

Few studies inform the frequency and type of adult male involvement in families in contact with child welfare, and even fewer explore how male involvement relates to child welfare outcomes. This study employed data from a sample of 3,978 families in contact with the U.S. child welfare system, drawn from the National Survey of Child and Adolescent Well-Being. The nature of male involvement in these families and its relationship to (a) caseworkers' perception of children's risk for maltreatment rereport and (b) entry into out-of-home care were explored. Results indicate that most caregivers report male involvement, distinct types of male involvement are related to the likelihood of out-of-home care, and households that include nonparental adult males are perceived by caseworkers as relatively risky. No male involvement indicator tested, however, was related to maltreatment rereport. Implications include the need to appropriately assess, include, and engage adult male family members across diverse family systems.

Salutogenesis as a framework for child protection: literature review

AIM

The aim of this paper is to demonstrate the usefulness of salutogenesis in work relating to child protection.

METHODS

A systematic review to explore the links between parenting, social factors and failure to thrive was carried out using 17 CD ROM and online databases using keywords in appropriate medical subject headings (MeSH terms) and Boolean operators refined for the studies. The salutogenic framework was then used as a way of clarifying what benefit particular research findings may have in identifying and using factors which can be associated with protection, safety and well being of children. Cross-referencing the evidence from the systematic review against Antonovsky's generalized resistance resources created a salutogenic matrix.

FINDINGS

Four factors in the systematic review were found crucially important: parent factors; parenting factors; child factors; and social factors. However, it is probable that these are useful within all child protection research and the evidence gathered in particular cases (here failure to thrive) could be plotted against each factor. Application of a salutogenic framework to the results was further illuminating and has utility for both systematic review methodology and other child protection explorations. The matrix created a warp and weft effect that identified gaps in current evidence and practice and was able to disentangle some of the complexities inherent within failure to thrive situations. By beginning to shed understanding on such processes, the concept of salutogenesis added further depth and rigour to the analysis.

CONCLUSIONS

The concept of salutogenesis is widely used in some areas of nursing practice and research, and can also be regarded as a theoretical tool that has potential in child care and protection research, development and practice. The paper also illustrates the importance of a sound theoretical framework in ensuring depth and rigour in analyses of literature review findings.

Early support needs of Finnish families with small children

AIMS

This study describes the early needs for support that families with small children have in the context of their own life situations. The study population consisted of Finnish families (n = 551) who participated in a project titled 'Families with Children' (1996-2001). The project supplemented the existing public services. The information provided by the study was utilized in supporting families and developing family work in seven experimental areas.

METHODS

The data were collected between 1997 and 2000 using family service plans and client reports. The data were analysed with inductive content analysis and using the SPSS software (version 7.5).

FINDINGS

The families needed support in the areas of parenthood, upbringing and child care, marital problems and social support networks. The need for early support was also connected to health problems of the children or the parents, problems with work or studies, unemployment, problems in economic or living conditions, or family crises. In addition to support, the families searched for help from family workers in disputes over child custody and visitation rights, intoxicant abuse and violence, and problems in adjusting to society. Each family had 4-5 needs for early support.

CONCLUSIONS

The results demonstrate that families with small children have many needs for which they seek help when there are available services supplementing the existing public services. The information provided by the study can be utilized in maternity and child welfare clinics, in social services and in family work provided by civic organizations to define the early needs of families for support and to develop services.

Focusing upon children and men in situations of domestic violence: an analysis of the gendered nature of British health visiting

Despite considerable feminist critiques of British health visiting work which have pointed to its gendered nature, this issue has received very little attention within the professional literature. The emphasis has been upon the 'health' focus, often highlighting the needs of marginalized groups. The recent professional interest in women experiencing domestic violence draws upon a long-standing feminist concern which has established the extent and nature of domestic violence, and the difficulties facing women in seeking help about their situation. The present paper reports some findings from a study of British health visiting practice in relation to women experiencing domestic violence. Drawing upon interview data from 24 health visitors, this paper focuses specifically upon health visitors' accounts of their practice in relation to both children and men when they were aware women were experiencing domestic violence. Their concerns, which include child welfare and personal safety illustrate some of the complexities facing practitioners when faced with domestic violence situations. The analysis also highlights the gendered practices inherent within health visiting work.

Supporting and policing mothers: an analysis of the disciplinary practices of health visiting

AIM

This paper draws on the notion of disciplinary power developed by Michel Foucault to discuss whether the professional practices inherent in British health visiting can be understood in terms of support or surveillance.

BACKGROUND

The notion of disciplinary power embedded within Foucault's writings has been widely applied to the sociological analysis of health care professions. While a number of studies have focused on nursing practice, there has been little empirical work developing these ideas in the context of British health visiting.

METHODS

A qualitative approach using interviews with 24 health visitors and 16 women who had experienced domestic violence was used. For reasons of confidentiality, the women were not matched to the health visitors. Data analysis was continuous with data collection and led to identification of a number of categories. The theoretical framework of feminist poststructuralism underpinned the analysis.

FINDINGS

The women who participated in this research described their engagement in a number of disciplinary practices. These included the discursive production of themselves as good mothers, subjects and objects of the health visiting gaze, as well as their practices of resistance to health visiting work. Analysis of the health visitors' interview data provided further evidence concerning the exercise of disciplinary power in their everyday work of providing support and health care to women and children.

CONCLUSIONS

The paper highlights tensions within the health visitor's role between welfare and surveillance, as well as differences between lay and professional perspectives.