Showing papers in "Child Welfare in 2001"

Foster youth transitions to adulthood: A longitudinal view of youth leaving care.

Abstract: The well-being of youths who age out of the out-of-home care system in the US has long been of great interest to child welfare practitioners and policymakers In spite of this interest, however, very little is known about how these youths fare when they must make the transition to independence The Foster Youth Transitions to Adulthood Study is tracking the experiences of 141 young adults who left care in Wisconsin in 1995 and 1996 This article describes these youths and their experiences in the first 12 to 18 months after leaving care The findings suggest that the transition to independence is a difficult time for youth leaving the out-of-home care system

Substance abuse and child welfare: clear linkages and promising responses

Abstract: Parental substance abuse is a significant factor in many of the families served in the child welfare system. This article examines: (1) the prevalence of substance abuse among families involved with the child welfare system; (2) the impact of substance abuse on child welfare practice; (3) how both the Adoption and Safe Families Act of 1997 and welfare reform legislation intensify the need to address parental substance abuse effectively; and (4) promising strategies for addressing these families' needs.

The postadoption experience: child, parent, and family predictors of family adjustment to adoption.

Abstract: Eighteen to 24 months after they adopted children in state custody, 159 parents were surveyed regarding their postadoption experiences. Most children remained with their new families, with parents reporting the adoption experience to be "about as hard as expected," and rating the past year of caring for the child as being more "smooth" than "stressful." Parents saw how the child contributed positively to their lives, were less positive about available social supports, and expressed dissatisfaction with the speed of the adoption, the availability of community supports, and the ability to link with supports. Children's special needs (e.g., older age at adoption) were predictive of postplacement adjustment.

A Multimodal Intervention for Grandparents Raising Grandchildren: Results of an Exploratory Study.

Abstract: This article describes the results of an exploratory study of a multimodal, home-based intervention designed to reduce psychological stress, improve physical and mental health, and strengthen the social support and resources of grandparents raising grandchildren. The six-month intervention included home visits by registered nurses, social workers, and legal assistants; the services of an attorney; and monthly support group meetings. The intervention resulted in improved mental health scores, decreased psychological distress scores, and increased social support scores. Participants also experienced improvement in the level of public benefits received and in their legal relationships with their grandchildren. Implications of these findings for practice are highlighted.

Substance-abusing child welfare parents: treatment and child placement outcomes.

Abstract: The authors present findings from their study of 167 child welfare parents referred for substance abuse assessments. Relationships between gender, prior treatment, court-ordered intervention, significant others' support, and treatment and placement outcomes are examined. Findings indicate significant others' support positively influences all outcomes while court-ordered intervention is not predictive. Prior treatment is associated with continued substance abuse. Gender differences exist for assessment completion and several client characteristics. Implications for practice are drawn. Substance abuse, including addiction, is a serious public health problem in the United States. Nearly 13.8 million adults abuse alcohol, including 8.1 million who are addicted (Grant et al., 1995). An estimated 13 million adults use illicit drugs or abuse prescription drugs, with approximately 3.5 million being chronic drug users (HHS/SAMSHA, 1996). Background Estimates of the numbers of children in the United States affected by parental substance abuse range from 8.3 million (Huang et al., 1998) to 17.5 million (Eigen & Rowden, 1995). The Child Welfare League of America (1997) found that parental substance abuse was present in at least half of the 970,000 child maltreatment cases in 1996. The National Committee to Prevent Child Abuse (1997) identifies parental substance abuse and poverty as the two major factors associated with placement of children. The U.S. Department of Health and Human Services (1997) reports growing numbers in foster care, with over 500,000 children in 1996, a 47% increase from the 340,000 cases in 1988. Caseworkers attribute both new entries and longer stays in large part to parents with chemical dependency (Tatara, 1992; Children's Defense Fund, 1995). The literature consistently reports the coexistence of substance abuse and child maltreatment in the same families (Arellano, 1996; Bavolek & Henderson, 1989; Coleman, 1987; Hindman, 1977; Jaudes et al., 1995; Potter-Efron 1990; Senate Report, 1980). Although research demonstrates the effectiveness of interventions with persons with drug and alcohol problems in the general population, relatively little is known about interventions with substance-abusing child welfare parents (Dore & Doris, 1997). The present study seeks to contribute to the small but growing body of literature on substance abuse interventions with child welfare parents. The literature suggests that gender mediates in all aspects of addiction and that prior treatment, court-ordered treatment, and significant others' support positively influence intervention outcomes. Gender The literature reports that males and females experience onset and progression of, and recovery from, substance abuse differently (Kauffman et al., 1997; Nelson-Zlupko et al., 1995). Although men are less likely than women to engage in help-seeking behavior and treatment for psychosocial problems, women are less likely than men to seek substance abuse services (Reed, 1987; Thom, 1986). Women tend to have lower treatment retention rates (Blume, 1990; Sansone, 1980) and to be underrepresented in substance abuse treatment (Center for Substance Abuse Treatment, 1994). Traditional treatment and 12-step recovery programs, based on a male model, do not meet the gender-specific needs of women, thus discouraging their involvement (Beckman, 1994; Finkelstein, 1994). Gender-specific treatment outcome data are needed to guide the design and adaptation of treatment methods specifically for women (Wilke, 1994). Prior Treatment Clients with prior treatment may be further along in the recovery process and better prepared to make a commitment to further treatment. In a study of a program developed to prevent the placement of children of substance-abusing parents, the most effective predictor of treatment completion and sobriety at three months after entry was previous treatment (Dore & Doris, 1997). …

Outcomes of family-centered residential treatment.

Abstract: This article describes a family-centered residential treatment model and presents results from a quasiexperimental study examining its effectiveness in achieving permanency outcomes for children. Greater postdischarge stability was achieved for participants in the family-centered program than in the agency's standard residential treatment service. Implications for child welfare policy and practice are highlighted.

Refugee children in Canada: searching for identity.

Abstract: Canada is providing a new home to refugees from around the globe, who have left their countries of origin because of persecution and are seeking safety elsewhere. These families bring with them myriad stresses arising from their migration. Child refugees, in particular, have special needs that must be consideredtrauma from witnessing violent crimes, language difficulties, family disruption, and adjustment to a different culture-in addition to the challenges that accompany childhood and growing up. Refugees are defined by the UN High Commissioner for Refugees (UNHCR) as persons (both children and adults) who are residing outside their countries and cannot return due to a well-founded fear of persecution because of their race, religion, nationality, political opinion, or membership in a particular social group. UNHCR estimates that one-half of the world's 22.3 million refugees and displaced persons are children. Every day, nearly 5,000 children become refugees, with a vast number growing up and spending their entire lives in refugee camps. The majority of refugees are located in Africa, Asia, and Europe (UNHCR, 2000). Canada as Host Canada has a longstanding humanitarian tradition toward refugees. Since the end of World War II, Canada has resettled about 800,000 refugees from every region of the world, including Europe, Asia, Africa, the Middle East, and Central and South America. Canada is one of the few countries in the world with an active resettlement and permanent immigration program. Nearly one in five (17.4%) persons living in Canada was born outside the country (by comparison, the U.S. ratio is one in 10) and 11.2% of the total population of 31 million identify themselves as members of a visible minority. Canada is a country with two official languages (English and French) and a national policy of multiculturalism (Statistics Canada, 1996). In the last five years (1995-1999), more than 300,000 immigrant children have resettled in Canada; approximately 15% of these are refugees. Seventy percent of the refugee children came from non-European countries, mainly Africa, the Middle East, Asia, and the Pacific region. Most of them have settled in large urban centres in the provinces of Ontario, Quebec, British Columbia, and Alberta. The majority of the refugee children (70%) spoke neither of Canada's official languages when they arrived in the country (Citizenship and Immigration Canada, 1995 & 1996; Citizenship and Immigration Canada, 2000). Refugee and Immigrant Children: A Comparison Refugee and immigrant children in Canada have significant similarities. Both groups must deal with migration, which represents a disruptive loss to one's life. Once in Canada, they both have to endure the "push-and-pull" forces of home and school, which often work in opposite directions. At school they share with other adolescents the desire to be accepted by their peer group. At home, both groups may experience a role and dependency reversal in which they may function as interpreters and "cultural brokers" for their parents. Both refugee and immigrant children may encounter society's discrimination and racism, and both have to accomplish the central task of childhood and adolescence-developing a sense of identity-while trying to bridge generational and cultural gaps. Perhaps the greatest threat to these children is not the stress of belonging to two cultures but the stress of belonging to none (Lee, 1988). Successful adaptation can bring with it the opportunity for growth. How well children adapt is influenced by several factors, including age at arrival, severity of previous traumatic events, family background, individual resiliency, and reception by the host community and society. One key factor in determining success is the reception of newcomers by the host society. Settlement support services, schools, health and social services, and the community at large play a crucial role in assisting and supporting children to adjust and integrate into Canadian society (Task Force on Mental Health Issues Affecting Immigrants and Refugees, 1988). …

Residential Substance Abuse Treatment for Pregnant and Postpartum Women and Their Children: Treatment and Policy Implications.

Abstract: In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.

Finnish children in foster care: evaluating the breakdown of long-term placements.

Abstract: Save the Children studied risk factors associated with placement disruption or breakdown in cases where long-term foster care was intended. Before their placement in 180 foster families, most of the 234 children studied (75%) had experienced neglect. The followup time after initial placement averaged four years and two months. Achieving long-term beneficial foster care placement of children of varied ages and experiences with abuse and neglect, involved considering the needs of the foster parents who may or may not have their own children or other children in their care. Some children were reunified with their parents; careful evaluation is needed before such reunion.

Combining Child Welfare and Substance Abuse Services: A Blended Model of Intervention.

Abstract: Montgomery County, Maryland's Child Welfare Services (CWS) and Adult Addiction Services (AAS) developed an initiative to address the requirements of the Adoption and Safe Families Act (ASFA) while meeting the needs of families and the community of providers. A blended model of intervention was determined to be the best strategy to achieve the dual mandates of CWS and alcohol and other drugs (AOD) providers. Drawing from criminal justice, systems theory, social work, and addiction treatment, the approach made use of graduated sanctions or levels of intensity in providing services, engaging client participation, and engendering motivation. This article proposes strategies at client and organizational levels to understand the process of adaptation to ASFA and to guide planning for blending services.

Effectively responding to the commercial sexual exploitation of children: a comprehensive approach to prevention protection and reintegration services.

Abstract: The commercial sexual exploitation of children is one of the most destructive forms of abuse. Although some efforts have been made to stop the trafficking in children and youth, they are far from sufficient. A coordinated local and global response is needed if this "ultimate evil" is to be ended.

Parenting services for families affected by substance abuse.

Abstract: This article describes the development, implementation, and replication of a group-based parenting program for families affected by substance abuse. The Nurturing Program for Families in Substance Abuse Treatment and Recovery improves parenting, as measured on objective scales; enhances parents' satisfaction and competence, as measured by participant reports; and is based on principles demonstrated to be effective in reducing risk of both child abuse and neglect and substance abuse for both parents and children.

Parental substance abuse and the development of children in family foster care.

Abstract: To determine the impact of parental substance abuse on children, the cognitive skills and behavior ratings of 268 school-age children placed in family foster care were examined. As a group, the children in family foster care presented with low average cognitive skills and made significant improvement in cognitive functioning during placement. The children with prenatal exposure to drugs scored significantly lower in cognitive skills at the beginning of placement but made significantly more progress than the other children during placement. Behavior ratings by the foster parents and teachers revealed that 29% of the children had scores in the significant range, and the children exposed prenatally to drugs had a higher incidence of behavior problems at school compared to family foster care peers. Recommendations for further study of these factors and for enhancing outcomes for children in care are provided.

Caregiver AOD use, case substantiation, and AOD treatment: studies based on two southwestern counties.

Abstract: This article includes two separate studies: the first explores the impact of caregiver AOD use on CPS case substantiation; the second compares CPS-involved and CPS-noninvolved females in AOD treatment systems. Results suggest that cases with indications of AOD use are more likely to be substantiated than cases without; and increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women. Related findings are also presented, followed by implications for practice and research.

Helping foster parents cope with separation, loss, and grief.

Abstract: Major changes in planning for children in foster care have resulted in significant changes in the roles of and expectations for foster parents, accompanied by even less attention to the issues of foster families' grief and loss. This article focuses on (1) the many ways foster parents encounter loss and grief on a continuous basis; (2) factors that affect the intensity of the loss and the healthy expression and resolution of grief; (3) problems that can result when the grief of foster parents is not adequately addressed; and (4) ways in which professionals can be helpful to these caregivers around loss and grief.

Outreach to birthfathers of children in out-of-home care.

Abstract: This article presents findings from a study of casework outreach to birthparents of children in out-of-home care The study explored whether the birthfather was being ignored as a resource for discharge planning It examined the outreach and interventions of caseworkers in three New York City out-of-home care agencies Casework activity levels were found to be higher for birthmothers than for birthfathers, and a complex relationship among the variables of gender, outreach, and response was revealed The nature and value of more specific outreach toward birthfathers of children in care and the risk of ignoring men in the birthfamily system are discussed

Paternal involvement in kinship foster care services in one father and multiple father families.

Abstract: Using data from case records and from questionnaires completed by caseworkers, this article describes contact between 132 fathers of children in kinship foster care and their caseworkers over a period of 12 months, and the fathers' involvement in permanency planning for their children. The data indicate that most fathers had no contact with the caseworkers during the period under study and had never participated in planning. Analysis revealed that paternal involvement varied significantly by the child's family composition. Fathers of two or more children from a one-father family were most involved, while fathers of one child from a multiple-father family were least involved. Possible explanations for the findings are identified, and implications for practice and research are presented. Little is known about the involvement of birthfathers in child welfare services or factors that affect paternal involvement. This lack of knowledge is remarkable, given the central role accorded parents in child welfare policy and practice. Federal policy, for example, requires state child welfare systems to attempt to keep maltreated children with their parents when the child's safety is not at serious risk and to allow birthparents to participate in permanency planning when their children are placed in out-of-home care. The importance of working with parents in child welfare interventions is also rooted in professional values and in practice methodologies. From a value perspective, the social work profession has long supported the notion that parents who want to provide good care for their children but are experiencing difficulties deserve an opportunity to strengthen their parenting capacities through supportive services. This value is consistent with the professional understanding that capable, nurturing parents can have a substantial, positive influence on their children's developmental outcomes. Since the 1970s, the child welfare profession has advocated a family-centered approach to child welfare services that emphasizes giving first consideration to maintaining children with their birthparents when the parents appear willing and capable of providing adequate care (Pecora et al., 1992). Practitioners have also long recognized that even those parents who cannot provide adequate care to their children may still give valuable assistance to those working in behalf of their children. This assistance may include access to financial benefits, the maintenance of a supportive relationship with the child, and, in more extreme situations, the voluntary relinquishment of parental rights so that a child may move more quickly into a permanent home. At the very least, parents are the sources of information that may be crucial to the child's current and future well-- being, such as the child's early developmental history, the child's genetic background, and resources available to the child in the extended birthfamily. Despite the emphasis on the importance of parents, the child welfare literature rarely addresses the involvement of fathers in planning and services (O'Donnell, 1995). The literature on programs such as family preservation and family reunification often assumes that child welfare work involves two-parent families even though studies over the past two decades have found that single-parent, female-headed households constitute a large segment of the families served by child welfare agencies (Shyne & Schroeder, 1978; Pecora et al., 1992). The literature usually makes no distinction between working with mothers and fathers either in one or two-parent homes. Except for occasional descriptions of the paternal role in specific minority cultures, such as Latinos, the literature rarely suggests that fathers may react differently than mothers to social service interventions or to the role of the child welfare worker. In addition, the literature provides little discussion of the challenges of working with the significant number of unmarried and noncustodial fathers whose children have been placed in out-of-home care. …

When the rehabilitation ideal fails: a study of parental rights termination.

Abstract: This study explored the circumstances of parents whose extreme neglect and abuse of their young children justified the drastic state action of termination of their parental rights. Records of 97 children age 6 and under whose parental rights were terminated between 1991 and 1997 in Minnesota were reviewed. Profiles of parents and children were drawn from these data, and a "risk pool" of parents whose children became wards of the state was identified. Guidelines are drawn from this "risk pool" that may help alert practitioners to those parents who are unlikely to safely maintain their children. Questions and implications for policy and practice are highlighted. Termination of parental rights (TPR) is an extreme action initiated by the state to irrevocably sever the legal bond between parent and child (Mnookin, 1975; Hewett, 1983; Katz, 1971; Rose, 1980; Garrison, 1983). The decision to legally sever the relationship between a child and parent requires a high standard of proof: "clear and convincing" evidence1 (Minn. Stat. sec 260.241, 1998). Because of the serious consequence of TPR, it has been described as equivalent to the death penalty in its finality and gravity (Hewett, 1983). In delivering the U.S. Supreme Court's opinion in a case involving TPR, Justice Ruth Bader Ginsberg called the "destruction of family bonds" a "devastatingly adverse action (M.L.P v. S.L.J., 1996, p. 18). Historically, TPR has been invoked hesitantly and sparingly. The child welfare system has instead focused its efforts on the rehabilitation of families, with the goal of reunifying maltreated children with their birthparents following out-of-home placement. This so-called "rehabilitation ideal" has shaped practice and policy since passage of the Adoption Assistance and Child Welfare Act (AACWA) of 1980. AACWA emphasized "reasonable efforts" toward reunifying families as a guiding principle (Seaberg, 1986). When an abused or neglected child is removed from the home after a finding of maltreatment, the child welfare agency provides family reunification services: working with maltreating parents to make the home safe for the child's return. Family preservation has been recognized as the primary goal of child welfare services, with intensive home-based services serving as the vehicle for the delivery of reunification services (Fraser, Pecora, & Haapala, 1991; Nelson, Emlen, Landsman, & Hutchinson, 1988). In the proliferation of studies evaluating family-based services that has emerged since AACWA's passage, a subtext has developed among a few studies: circumstances have been identified in which rehabilitation efforts are not likely to be successful (e.g., Nelson et al., 1988; Maluccio, Fein, & Davis, 1994; Barth & Berry, 1987; Frankel, 1988; Pelton, 1994; Rzepnicki, 1994; Littell, 1997). As data emerged in the 1990s documenting the rise of placements and long stays in out-of-home care without a permanency plan, more serious questions have been raised about the value of prolonged attempts at rehabilitation (Earth, Berrick, & Gilbert, 1994). In 1997, substantial shifts in the historic hesitancy to invoke TPR occurred with the passage of the Adoption and Safe Families Act (ASFA) (P.L. 105-89). ASFA encourages decisions on permanency within an expedited timeframe. It stresses the health and safety of the child as a "paramount concern," and to this end, provides both mandatory and optional directives to the states for expediting TPR. Several aspects of ASFA are designed to curtail the length of time a child can "drift" in out-of-home care without a plan for a permanent home (Hardin, 1999). First, ASFA allows states to bypass "reasonable efforts" to preserve and reunify the families if: parents subject children to "aggravated circumstance"2 or commit certain violent crimes against children (e.g., murder, assault); or if the parental rights to a sibling of the child have previously been terminated involuntarily. …

The role of spirituality in the recovery process

Abstract: Though innovative approaches to working with substance-abusing parents of maltreated children have emerged within the last few years, child welfare agencies continue to be challenged by the chronic nature of addictive diseases This article discusses the often ignored element of spirituality as a critical component of recovery for parents It also highlights how the regulation of spirituality by parents has a significant influence on their ability to responsibly care for their children

Treating substance-using women and their children in public housing: preliminary evaluation findings.

Abstract: The Key West Housing Authority created SafePort, a residential substance abuse treatment program within public housing to provide drug treatment to parenting women All family members-women, children, and significant others-receive comprehensive assessments to determine appropriate therapeutic interventions to resolve their problems Preliminary evaluation findings suggest that women who participate with their children are more likely to remain drug free than are those who participated without their children Recent federal health financing and health care delivery programs have increased access to alcohol and other drug (AOD) abuse treatment programs for low-income women, and have provided intervention and prevention services for their children and families [Center for Substance Abuse Treatment, 1994; Coletti et al 1992; Hughes et al 1995; Kronstadt 1991; Metsch et al 1995, 1999; Rahdert 1996; US Department of Health and Human Services 1992a, 1992b] Demonstration research and service programs have been initiated to verify that comprehensive, long-term residential treatment services for women will decrease alcohol and other drug use, reduce reliance on social and health welfare programs, and improve functioning in specific life-skill and vocational areas A unique aspect of these programs is the addition of arranged child care, either onsite or offsite, which allows for the provision of intervention and prevention services for the clients' children in a safe and supportive environment These programs are primarily client-centered; nevertheless, the curricula also include family-focused components, such as parenting classes and family outreach programs In general, the most successful long-term benefits occur among clients who complete programs that most closely meet their needs and provide coordinated services such as social and medical care [Cottler & Lyndly 1992; McLellan et al 1998] and even housing for homeless mothers and their children [Smith et al 1995] This trend appears even more pronounced among evaluations of treatment programs for substance-abusing women A review of recent literature finds that women's treatment program curricula consider the following characteristics and components vital: (1) support for survivors of incest, sexual abuse, and domestic violence [Welle et al 1998; Cosden & Cortez-Ison 1999]; (2) flexibility to be responsive to feedback from clients and staff [Whiteside-Mandell et al 1999]; (3) outreach to locate women likely to enter treatment [Howell & Chasnoff 1999]; and (4) intensive case management to link women and their families with social services [Howell & Chasnoff 1999] Earlier published studies from such women-centered programs have shown generally superior treatment outcomes, such as reduced antisocial behavior, decreased criminal activity, and increased length of stay in treatment [Coletti et al 1992; Saunders 1992; Stevens et al 1989; Cuskey et al 1980] Stevens and colleagues [1989] and Coletti and associates [1992], referring to two independent programs, reported that programmatic changes addressing women's needs and accommodating children led to better program retention and increased length of stay among women in treatment (see also Hughes et al [1995]) More recently, an Arkansas program designed to treat drug-using pregnant women found that program participation was associated with a significant reduction in drug use before the birth of the target child, fewer pregnancy complications, and higher birth weights for the targeted children than among women who did not participate [Whiteside-Mandell et al 1999] Metsch and colleagues [1999] interviewed women who had attended a family-centered treatment program that provided housing arrangements for the entire family and child care for mothers while they attended treatment activities [cf Metsch et al 1995] Multivariate analyses found that a high school education, treatment duration of more than one year, and participation in the treatment facility's aftercare program were independently and positively related to gainful employment [Metsch et al …

How soon is too soon? Addiction recovery and family reunification.

Abstract: This article describes the addiction recovery process and its impact on parenting behaviors-information needed by child welfare workers involved in decisionmaking regarding family reunification. Two models of recovery-from alcoholism and from cocaine addiction-are reviewed, along with issues encountered in recovery, particularly for women. Case examples and discussion demonstrate how child welfare workers can apply these models in determining the appropriateness of reunification. An ongoing concern for child welfare workers involved in family reunification work is deciding how soon to return a child to a parent who has been through addiction or related treatment and who has stopped using substances. Workers often wonder whether a parent really is in recovery and what behaviors and attitudes on the part of the parent would indicate this. Such decisionmaking is difficult, as the courts prefer to see families reunited quickly, while addiction treatment providers argue for longer timelines so that clients can solidify treatment gains [Azzi-Lessing & Olsen 1996]. This article describes the process of recovery, the behaviors and attitudes that indicate recovery, and how recovery impacts parenting. Two case examples applying this knowledge are presented, along with a discussion of their application to practice. Alcoholism Recovery as a Developmental Process Only in the last 15 to 20 years have researchers begun to study recovery as a clinical process distinct from getting a client sober or straight [Brown 1985; Allsop & Saunders 1989; Marlatt 1985]. In her study of alcoholics in Alcoholics Anonymous (A.A.), Brown [1985: 55] created a developmental model of recovery that is widely used in the addictions field today. The model is based on behavioral change, cognitive change and reconstruction, and "object substitution and replacement." According to Brown [1985], recovery comprises three major components: (1) acceptance of the ongoing role of alcohol (or drugs), (2) adjustment to environmental changes, and (3) one's interpretation of one's self and others. The substance (alcohol or drugs) must maintain a continual organizing role in the individual's life. Although it is no longer important in the recovering person's life, it serves as an omnipresent reminder of the change that has taken place. Environmental changes are the major life changes and adjustments that an alcoholic/addict must make to sustain recovery (e.g., not spending time with other addicts; quitting a job as a bartender). These adjustments may also include coping with internal reactions to change, such as depression. The interpretation of one's self and others is based on the new identity the alcoholic/addict has chosen and the views of one's self and others that are constructed and reconstructed. There are four stages in this developmental model of recovery: (1) drinking, (2) transition, (3) early recovery, and (4) ongoing recovery. The drinking stage of alcoholism/addiction is marked by the consumption of the substance, along with increasing loss of control (i.e., problems with family, work, and other systems due to the substance use). At some point, the alcoholic/ addict reaches a point characterized by despair and recognition of the loss of control. For parents, this point may include the removal of their children [Dore et al. 1995]. In the transition stage of recovery, the alcoholic/addict embarks upon abstinence. This abstinence can arise from external forces (e.g., court-mandated treatment) or from internal desires to pull one's life together. According to Brown [1985], recovery is a fluid process during which the alcoholic/addict shifts back and forth in his or her belief that the addiction can be controlled or is out of control. The alcoholic may return to the earlier drinking stage if he or she believes that the drinking really isn't a problem or can be controlled. The early recovery stage is marked by abstinence, and according to Brown's [1985] research, the assumption of the identity of being an alcoholic/addict. …

Kinship care of the abused child: the New Zealand experience.

Abstract: The concept of continuity--keeping children within their own kinship, community, and cultural networks--has found international favor in contemporary child welfare practice. This principle is reflected in the 1989 New Zealand Children, Young Persons, and Their Families Act. The Act represents a significant shift--from the state to the family--in responsibility for children in need of care. The increasing use of the Family Group Conference process allows families to make decisions about the future of kin children and reflects the belief that, although most abuse is intrafamilial, the family will also be the most committed to keeping the child safe. Other countries have adapted this model to suit their own cultural child welfare needs. The international trend toward formal use of kinship care for children who have suffered abuse or neglect is likely to continue as foster care resources shrink. Drawing on qualitative research, this article describes the experiences of caregivers and their kin children who have been the subject of a care and protection order.

Upping the ante: relative caregivers' perceptions of changes in child welfare policies.

Abstract: Thirty-five caregivers of related children who were in the custody of the child welfare system were interviewed individually or in focus groups as the state child welfare system implemented new federal and state policies encouraging these caregivers to adopt or assume guardianship of the children in their care. Interviews were transcribed and analyzed using qualitative methods. Issues of concern included emergency entrance into caregiving; the simultaneous satisfaction and burden of caregiving; obstacles to caregiving, adoption, or guardianship; complex changes in family dynamics following placement of children; sources of support; and caution regarding adoption or guardianship. The caregivers also offered recommendations for the child welfare system. Policy, practice, and research implications are discussed. Historically, kin have cared for children when parents have been temporarily or permanently incapacitated. In some cases, kin have informally adopted children (Child Welfare League of America, 1994; Hegar & Scannapieco, 1995; Hill 1972,1977; Martin & Martin, 1978; Scannapieco & Jackson, 1996; Stack, 1974; Timberlake & Chipungu, 1992). In others, several relatives share parenting responsibilities until teen parents mature and assume major responsibility for child rearing. This "informal kinship care," is usually provided without involvement of the child welfare system. Kinship care has recently become a part of the formal child welfare system (Gleeson & Craig, 1994) through arrangements referred to as "kinship foster care," "relative foster care," or "formal kinship care." In the mid-1980s, the number of children in state custody and living with relatives increased sharply, particularly in major urban centers (Gleeson & Craig, 1994; Kusserow, 1992a, 1992b; Wulczyn, Harden, & Goerge, 1997). Now, approximately one-third of all children in out-of-home care in the United States live with relatives (Harden, Clark, & Maguire, 1997). In California, Illinois, and New York, 40% to 50% of children in care are in kinship care. At one time, 57% of the children in out-ofhome care in Illinois were living with kin (Illinois Department of Children and Family Services [IDCFS], 1995; Testa, 1995, 1997; Wulczyn et al., 1997). The growth in kinship foster care has coincided with the overall growth in foster care. In 1995, the national foster care caseload approached an all-time high of 500,000 children in foster care on any day. As the caseload grew, so did cost and public concern. Congressional efforts to reform the child welfare system and President Clinton's Adoption 2002 directive ultimately led to passage of the Adoption and Safe Families Act of 1997 (P.L.105-89) (ASIA). ASIA increased the frequency of mandated case reviews, shortened the timeframe for case decisionmaking and achieving permanency, eliminated the requirement to make reasonable efforts to reunify children with parents in cases of egregious harm, and encouraged faster termination of parental rights and adoption, thus reducing the time allowed to parents to meet requirements for reunification. Although ASIA does not require states to apply the same time limits to kinship care as it does to other out-ofhome placements, Illinois, a state with a particularly high kinship care caseload, has focused its permanency planning and caseload reduction efforts first on kinship care and then on nonrelative foster care. The study described here was designed to promote understanding of the experiences and reactions of kinship caregivers to the child welfare system's pressure to adopt or to assume private guardianship of related children. It is intended to amplify the voices of caregivers, based upon focus group and individual interviews with kinship caregivers conducted between June 1998 and June 1999, as permanency planning and caseload reduction efforts were being implemented. Caregiving Experiences and Consequences Kinship foster caregivers share similar demographics (Berrick, Barth, & Needell, 1994; Harden et al. …

Research outcomes of prenatal substance exposure and the need to review policies and procedures regarding child abuse reporting.

Abstract: Research on the outcomes of drug-exposed children evinces elevated developmental risks from the interaction of subtle biological vulnerabilities and compromised parenting. States, however, have generally not reviewed the procedures and policies they developed in the early 1990s when there was less research and experience with these children. At that time the gravest risks related to perinatal substance exposure seemed to be excessively punitive treatment of mothers by overzealous criminal justice prosecutors. This article clarifies policy options for reporting and serving children who are born testing positive for controlled substances and also calls for strengthening existing state policies regarding child abuse reporting and response. Child welfare services touch the lives of at least three million children each year, with at least one million children receiving ongoing services at home or in out-of-home care. About one in eight children (13%) were less than 12 months of age at the time they were reported to child welfare. [Barth et al. 2000]; of these children almost 82% (with known reasons for reporting) were reported for reasons of neglect. Young children continue to be the largest group entering out-of-home care-approximately one in five admissions into care is for infants and about half of those are for newborns [Wulczyn et al. 1999]. Infants' lengths of stay in out-of-home care are exceptionally long, in part due to the high proportion-about one-third [Wulczyn et al. 1999]-that will experience the lengthy process of adoption. Although there is no certainty about the proportion of cases that are reported to child welfare services stemming from substance abuse, there is a consensus that it is so far the majority of cases [U.S. Department of Health and Human Services 1999]. More than three-quarters of state child protection administrators across the country report substance abuse as one of the top two problems presented by their caseloads [Weise & Daro 1995]. A decade ago, Besharov [1989] concluded that over 73% of neglect-related child fatalities in 1987 were attributable to parental alcohol and drug abuse. Child Welfare Policy Regarding Infants Born Exposed to Substances In the late 1980s and early 1990s, states struggled with policy decisions about handling the many child abuse cases that were based on exposure to crack cocaine. Although the issue of children being born exposed to drugs was not new for child welfare [Fanshel 1975], the size of the population of concern in metropolitan hospitals was startling to the public. Coupled with early reports of the possibility of serious lifetime harms from prenatal crack cocaine exposure, some child welfare agencies became involved in massive increases in the placement of children into out-of-home care. In some communities, one-fifth of all newborns were placed into care [Wulczyn 1994]. New York state had consecutive annual foster care caseload increases of 28%, 29%, and 26% between 1986 and 1989-more than doubling its out-of-home care census in that time. Child welfare administrators, judges, and advocates for children and drug-involved parents began to call for clarification about the procedures by which children should be determined to need which child welfare intervention following what process. At that time, the empirical basis for making that determination was inadequate. Policy decisions had to be made, nonetheless, and states chose approaches based, substantially, on political considerations of interest groups. A few states and counties opted to incarcerate pregnant mothers who used substances, but this option was not embraced by enough interested parties to be seriously considered. (Indeed such punitive proposals seemed to coalesce professionals opposed to all actions that appeared "punitive," including mandated reports.) The most common options that states adopted were: * a positive drug-test for a child at birth as grounds for an automatic child abuse and neglect report (as in Iowa); * a positive infant drug test serving as the basis for a substantiated child abuse and neglect finding (as in South Carolina); * a positive drug test as grounds for referral to a maternal and child health agency (MCHA) and nothing more (as in California); or * silence about the appropriate responses (as in Maryland). …

Factors affecting mother-child visiting identified by women with histories of substance abuse and child custody loss.

Abstract: The influence of maternal substance abuse upon the placement of children in out-of-home care increased significantly in the 1980s and 1990s, affecting mother-child visiting in numerous ways. Content analysis of interview data from 15 mothers with histories of illegal drug use and child custody loss provides insight into five major factors that can promote or inhibit visiting: (1) mother's drug use and health status, (2) effects of visits on the child, (3) transportation, (4) scheduling/ visit settings, and (5) support of others.

Models of intervention for children in difficult circumstances in South Africa.

Abstract: Advances in policy have helped to create interventions for children in difficult circumstances in South Africa. This article examines models addressing children suffering abuse and neglect and children affected by HIV/ AIDS. The focus is on innovative local attempts to deal with these problems, rather than theoretical reflection. Larger programs are usually conducted by government agencies because they have more resources but valuable solutions have also been created by NGOs. South Africa's first democratic elections in 1994 heralded the beginning of numerous policy changes, including the creation of two key welfare policies: the White Paper for Social Welfare (Department of Welfare and Population Development, 1997) and the policy proposals of the Inter-Ministerial Committee (IMC) on Young People at Risk (Department of Welfare and Population Development, 1996). These policies embrace the following practice principles: securing basic welfare rights; equity; nondiscrimination; democracy; improved quality of life; human rights; investment in human capital; sustainability; partnership; intersectoral collaboration; decentralisation of service delivery; accessibility; appropriateness; continuity of care; family preservation; normalisation (as opposed to institutionalisation); and child, family, and community-centred practice. The author served as a national collator to document and evaluate several models of intervention for children in difficult circumstances (presented in a series of four national conferences') against these principles. It is vital to revisit these principles so that we distinguish between political rhetoric and morally active practice; view them against a previous oligarchy that fostered values antithetical to that of the new policy documents; and heed the lessons presented by history, as eloquently described by Fanon (1963).2 Social workers need to act as advocates for those most disadvantaged in society by exerting pressure on the government to deliver on its stated principles and by lobbying for structural changes that maintain people in disempowered positions. This is particularly true as South Africa's participatory and socialist democratic ideals are being compromised by the Growth, Employment, and Redistribution Strategy (Ministry of Finance, 1996), a macroeconomic policy based on the principles of neoliberalism with dire consequences for the welfare sector (Sewpaul, 2000a). This article describes models of intervention for two areas of children in difficult circumstances: children who are subject to abuse and neglect and children infected with and affected by HIV/AIDS, as they represent two of the most distressing child care problems in South Africa. Intervention Models for Child Abuse and Neglect Direct abuse and neglect of children within households is a major concern in South Africa, with the number of reported crimes against children increasing 11.7% between 1993 and 1996 (Department of Welfare and Population Development, 1996/1997). As highlighted by the IMC, several institutional and structural sources of abuse exist as well. Policy and practice options, such as the National Strategy on Child Abuse and Neglect, the Gauteng Programme of Action for Children (GPAC), the whole school multidisciplinary model, and the Isolabantwana/Eye on the Children Project, developed in response to these problems, are discussed below. The National Strategy on Child Abuse and Neglect The components identified by the National Committee on Child Abuse and Neglect (NCCAN) as essential to the National Strategy on Child Abuse and Neglect were: research; clarification of the responsibilities of government and nongovernment structures; resources and coordination of all components of the child protection system; the balancing of preventive, development, and treatment approaches; reporting and data collection; standardised management protocols; advocacy, policy development, and legal reform; and monitoring (September & Loffell, 1998). …

The education problems of migrant children in Shanghai.

Abstract: Due to social discrimination and economic reasons, migrant children in Shanghai often are excluded from local school systems. Resident migrants have established schools for their children but suffer from a lack of supplies, poor conditions, and untrained teachers. Thus far, government attempts at improving the education of migrant children have been less than successful. Suggestions for improving the educational outlook are offered.

Health care policies for children in out-of-home care.

Abstract: Placement in out-of-home care is one intervention used to protect children from abuse and neglect. While children are in such care, it is the child welfare agency's responsibility to ensure that their health needs are met. The study reported here examined health care policies and services for children in 46 state child welfare agencies. Virtually all states had some sort of written policies regarding health care for children in out-of-home care. Half, however, reported having no information management system to record health care data, and only six of the 23 had computerized systems. Most states fell short of meeting the standards set by the Child Welfare League of America for the health care of children in out-of-home care.

The multinational transfer of competency-based foster parent assessment, selection, and training: a nine-country case study.

Abstract: The UN Convention on the Rights of the Child mandates (Articles 19 and 20) that alternative care be available to protect children from maltreatment by parents and caregivers. Increasingly, countries around the world have recognized the benefits to child well-being of family-based care as an alternative to institutional care. The special if not extraordinary needs of children separated from parents because of abuse, neglect, and maltreatment and placed with foster families requires a commensurate effort to develop foster families who have special if not extraordinary skills. Methods that are effective and replicable across countries offer significant advantages, reducing investments in policies and practices that otherwise would have to be developed independently, country by country. This case study describes the factors that contributed to the transfer of knowledge in the assessment, selection, and training of foster parents and the impact to date. The special and sometimes extraordinary needs of children separated from their parents because of abuse, neglect, abandonment, or other circumstances are compelling, requiring a commensurate effort to develop and support foster parents who have special, if not extraordinary skills (National Commission on Family Foster Care, 1991). Developing and implementing methods to help foster parents become part of a team to provide protection and permanency outcomes has been a continuing challenge for decades, entailing considerable human and financial resources. Relying on methods that not only have proven effective but also can be replicated and/or adapted across national borders offers significant advantages, such as reducing investments in policies and practices that otherwise would have to be developed independently country-by-country through trial and error. The transnational migration of such technology is important in light of the increasingly complex social issues facing child welfare systems around the world. The trend is in steadily escalating service challenges of at-risk children, youth, and families, as well as heightened political and media attention. Historical Perspective Over the past 25 years, the use in the United States of standardized approaches to foster parent assessment, selection, and training has become common. The pioneering transfer of this technology to the Netherlands was initiated in 1987 by the Dutch youth welfare foundation Op Kleine Schaal ("On Small Scale" or OKS), which concluded it would be more cost effective to adapt a program already developed and implemented in another country than to create a new model. OKS selected the American "Model Approach to Partnerships in Parenting" (MAPP), created in 1985 (Pasztor, 1986). The methods used to determine if the model could be adapted to the Dutch situation were explained in Child Welfare's first international issue (van Pagee, et al., 1991). At that time, more than a dozen Dutch foster care organizations were trained to implement the model, resulting in almost 100 foster families being recruited, selected, and trained to work as partners in protection and permanency for children. By 1996, more than 50% of all new foster parents in the Netherlands (about 400 families a year) were developed through the Dutch application of the transfer model, and major policy and practice foster care reforms were created as well. Additionally, transfer to Flemish-speaking provinces in neighboring Belgium resulted in over 50% of the agencies in that region adapting the program. News of these endeavors spread through international groups, such as the International Foster Care Organization (IFCO). In 1992, when child welfare agencies from Sweden and Finland were searching for a foster parent training/assessment program, they learned about the American/Dutch/Flemish transfer experience and a recently developed program, PRIDE, a competency-based approach to foster parent assessment, selection, and training (Illinois Department of Children and Family Services, 1996). …

Strengthening the roles of existing structures by breaking down barriers and building up bridges: intensifying HIV/AIDS awareness, outreach, and intervention in Uganda.

Abstract: A major repercussion of the HIV/AIDS epidemic is the challenge of caring for the children who have been dramatically affected by watching their parents fall sick, become incapacitated, lose their jobs, become stigmatized, and die. The biopsychosocial impact on these children is compelling. The Eaglets Child Welfare Project is working to identify community-based problem-solving strategies to address the needs of children orphaned by HIV/AIDS. This article describes the impact of the epidemic, the project's methodology, and lessons learned to assist in bringing down barriers and building bridges. Worldwide, more than 36 million people are living with HIV, and more than 40% of women attending prenatal clinics in urban areas are HIV positive, according to UNAIDS, the Joint United Nations Program on HIV/AIDS (1998). These figures are more than 50% higher than those projected in 1991 by the World Health Organization's (WHO) Global Program on AIDS, on the basis of the data then available (UNAIDS/WHO AIDS). As of 1998, 8.2 million children had lost their mothers to AIDS. Many of these children were orphaned as their fathers succumbed as well. In the same year, 800,000 children under age 15 became infected with HIV; by the end of 2000, an estimated 1.4 million children under age 15 were living with HIV (UNAIDS/WHO 2000). Since the beginning of the epidemic, according to UNAIDS and WHO estimates, well over two million HIV-positive children have been born to HIV-positive mothers, and hundred of thousands of children have acquired HIV from blood transfusions or through sexual activity (UNAIDS/WHO 1998). Because HIV infection in children often progresses quickly to AIDS, most of the nearly four million children under age 15 who have been infected since the start of the epidemic have developed AIDS, and many children have died. Of the 1.8 million people who died of AIDS in 1998, 650,000 were children under age 15. The U.S. Bureau of the Census (1998) has estimated that, if the spread of HIV is not contained, infant mortality from AIDS may increase by as much as 75% by 2010. Mortality in children under age 5 may jump by more than 100% in those regions of the world most affected by the disease. The Impact of HIV/AIDS in Uganda Caring for children orphaned by HIV /AIDS is a large problem in Ugandan society, with compelling biopsychosocial as well as economic implications. Data provided by the U.S. Bureau of the Census and the World Bank (1998) indicate that more than one million Ugandan children and youth have lost at least one parent to AIDS. This figure is increasing by an estimated 50,000 children each year. The effects of HIV infection and disease have combined with the high levels of poverty and the after effects of war to create a vacuum in the social support systems within Ugandan communities. Children are especially vulnerable. Often, they cease to receive sufficient parental care and support long before their parents and guardians lose their jobs, their sources of household income, and, eventually, their lives. Additionally, political insurgency over the past decades has resulted in the deaths of many parents and other caregivers. Vulnerable children who previously had to cope with long-existing issues and problems caused by indigenous poverty and wars are seeing their problems exacerbated by the HIV/AIDS epidemic. Images of the children who are suffering from this epidemic-from sick and neglected infants dying of AIDS in parentless homes to young people watching over their dying parents-provide disturbing graphic reminders on a global basis. The 1991 census in Uganda estimated that approximately 2.5 million children were orphaned due to the death of their parents from natural causes, war, and AIDS. Of these, about 12% were under 5 years of age, and about 88% were between 5 and 18 years of age. The districts most affected in Uganda are Masaka, Rakai, and Kalangala, where about 6% of the population are orphans. …