Work With Families
Family and Child Welfare
Step Six of the Decision Tree
Chapter 15
Family Welfare and Protective Services
As A Method of Family Practice
• When family welfare or protective services are
indicated (step six) competent practice requires
familiarity with both services.
• The goals of service delivery to families are:
(1)Model One: to prevent or mitigate the effects
of poverty, (2) Model Two: to protect family
members from abuse and neglect.
• Social work is distinguished as a profession by its
history of service to impoverished individuals and
families through policy and program initiatives &
direct, face–to-face, service delivery.
The Helping Relationship
Family Economic Welfare
• The helping relationship between worker and
family is circumscribed by the worker’s fiduciary
responsibilities.
• A specific set of skills, different from the skills
needed to enact family therapy (chapter 14), are
needed to work with children and families
receiving social welfare services.
• The desired end-goal of economic welfare is the
distribution of resources to meet basic human
needs consistent with a just and humane society.
The Helping Relationship
Family Economic Welfare
• When distributing resources to families,
social workers also exercise social control
by regulating access e.g. determining
eligibility and monitoring compliance.
Theories & Approaches
Welfare Service Delivery
Sociological theories and approaches used to
inform the delivery of family and child welfare
services are: (1) structure-functional theory, (2)
role theory, (3) critical theory, (4) afro-centric
theory (5) empowerment theory, (6) crisis
intervention theory (leading to foster care, kinship
care, reunification, or family preservation),
(7) strengths perspective and (8) post modern
principles
Family as a Sociological
Construct
• In the context of family and child welfare, the
family is recognized as a sociological construct.
• Society has a stake in the family as a societal
institution.
• As a societal institution, the family is responsible
for meeting the instrumental and expressive needs
of its members e.g. procreation, protection,
education, and socialization.
The Family As a Sociological Construct
Structure-Functional Theory: Parsons
• The application of General Systems theory to
society and its institutions is referred to as
Structure-Functional theory.
• Parson argues that families must function in a
manner that sustains the integrity of society as a
system (law and order perspective).
• Families that do not fulfill their duties (or roles) as
expected pose a danger to self ( their members)
and others (community).
The Family As a Sociological Construct
Structure-Functional Theory: Parsons
• Parson’s perspective is consistent with social
conservatism and the social control (fiduciary)
function of social work.
• Acting on behalf of society, social work has a
fiduciary obligation to ensure that families have
their basic needs for food, shelter (housing),
clothing, health and education met.
• Social work has a fiduciary obligation to ensure
the safety of family members (partner abuse, child
neglect & abuse, and elder neglect & abuse).
The Family As a Sociological Construct
Structure-Functional Theory: Geismar
• Consistent with Parson’s perspective, Family
Centered Casework (50’-60’s) held that families
who received economic welfare or who were
referred for protective services, were not fulfilling
normative roles and functions as expected by
society (Geismar).
• Casework accompanied service delivery (19561967) based on the premise that family centered
casework services could resolve problematic
family functioning.
The Family As a Sociological Construct
Structure-Functional Theory: Geismar
• In protective services, one family structure
(temporary foster family care) was substituted for
another (parental family care) while families
acquired (through casework) the skills and
resources they needed to function effectively.
• In 1967 congress officially severed casework
services from cash assistance programs.
The Family As a Sociological Construct
Structure-Functional Theory: Merton
• Merton challenged Parson’s theory on the basis
that it promoted unexamined acceptance of society
as the normative system in need of maintenance;
preference for the status quo.
• Merton argued that societal forces and dynamics
cause family dysfunction e.g. what society as
whole demands can be detrimental to individual
families- low wages, two wage earners, limited
paternity leave, unaffordable child care, etc.
• This school of thought is consistent with social
work activism and reform.
Model One
The Family As A Economic Unit
• In contrast to the psychological depiction of
family dynamics in chapter 14, sociologists hold
that socio-economic factors dictate how members
of a family relate to one another.
• Family functioning is closely related to the
economic and social structure of a society.
• Economics and social stratification (not
transactional patterns) either helps or disrupts
family structure and function.
Model One: Family Welfare
Social Stratification
• In societies, families are embedded in racial and
class hierarchies.
• Consequently families have different access to
resources that support families.
• Middle and upper class families are privileged in
that they have access to medical coverage,
expense accounts, and credit cards.
• Middle and upper class families have occupational
roles that are highly valued by society and
consequently earn higher incomes.
Model One: Family Welfare
Poverty Statistics
• The following data comes from CWLA; National
Fact Sheet 2004
• 12 million (16%) of US children live in poverty;
$14,600/yr for a family of three.
• 5 million (7%) in extreme poverty (family of 4
$8,980/yr)
• 27 million (37%) live in near-poor or low-income
families.
• 42% of poor children had a working parent
Model One: Family Welfare
Causal Hypotheses of Poverty
(1) Family Causality :The family, as a primary
economic unit, is charged with the responsibility
of meeting the basic financial needs of its
members (Structure-functional theory).
(2) Personal tragedy: Poverty can result from
personal tragedy; death, disability or old age of
the wage earner.
(3) Social factors: Poverty is an outcome of social
factors such as discrimination, oppression, and
exploitation.
Model One: Family Welfare
Causal Hypotheses of Poverty
(4) Economic Systems: Poverty is an outcome of
economic systems:
Communism because of economic stagnation and
irregularities in supply-demand
Capitalism because of flawed market mechanisms
and unequal distribution of opportunities and
benefits e.g results in layoffs, outsourcing,
minimum wages, part-time or seasonal work, etc.
Model One: Family Welfare
Solutions: Policies and Programs
• Social policies and programs attempt to ensure the
economic stability of families.
• There are two types of programs:
(1) Social Security Insurance: (work history).
-Protects workers and their dependents from
poverty due to loss of income caused by the
death, disability, old age or unemployment of
the primary wage earner.
-Programs are universal and non-stigmatized.
Model One: Family Welfare
Solutions: Policies and Programs
(2) Public Assistance (no work history/wages below
poverty). Programs are needs-based, means–
tested and stigmatized. Programs include:
-Temporary Financial Assistance to Needy
Families (TANF).
- Nutrition and Food Stamp programs
- Housing programs
- Health programs-Medicaid.
Model One: Family Welfare
Funding Welfare Programs
• Social Security programs are financed through
premiums paid by both workers and employers.
The Federal government administers the program.
• Public Assistance programs are jointly financed
by Federal Block grants and State funds from
general tax revenues. State and local Departments
of Health and Human Services administer the
programs.
Economic Welfare
Historical Perspective
• ADC: Historically, public assistance (financial
aid) was provided under the Social Security Act of
of 1935 -Aid to Dependent Children (ADC). Cash
aid was given to impoverished families with
dependent children on behalf of each child in the
family.
• AFDC: In the 1950’s the program was expanded
to make the caretaker also eligible for cash
assistance.; however only households without a
father were eligible.
Welfare Reform
Historical Perspective
• PROWR: (1996) The Personal Responsibility and
Work Opportunity Reconciliation Act (PRWORA,
P.L. 104-193); welfare reform. This act created
state run programs of Temporary Assistance to
Needy Families (TANF) .
• TANF: Funded by federal block grants and state
revenues, this program imposes strict work
registration, a training requirement, an
employment requirement and time limits to
receive financial assistance.
Economic Welfare
Historical Perspective
• EITC: Earned Income Tax Credit: Revenue
Act of 1978 P.L. 95-600. This program is
designed to support the working poor by
refunding earned income through a tax
credit program. Some states have followed
the lead of the federal government and offer
State EITC.
In-Kind Benefits
Hunger: Statistics
CWLA National Fact Sheet (2004)
• 1 in 25 children and 1 of 9 poor children lived in
households where adults had difficulty securing
food. Members experienced moderate hunger.
(1999)
• 2.3 million Americans received emergency hunger
relief in 2000.
• There was an increase of 18% in requests for
hunger relief in 25 major cities from 2002 to 2003.
In-Kind Benefits
Hunger: Programs
•
•
•
•
Food Stamps - Food Stamp Act 1974, P.L. 93-86
School breakfast programs
Summer food service
Supplemental nutrition program for women,
infants, and children, (WIC)
• Special milk program for children
• National school lunch program; (28 million
children served in 2003)
• Homeless children nutrition program
In-Kind Benefits
Housing: Statistics
• An estimated 2.3 million people experience
homelessness at some point each year.
• Of this number more than 1 million are children
• 2003, 40% of the homeless population in 25 major
cities, included families with children.
• Almost 75% of poor households spend more than
30% of their income on rent and utilities.
• The number of affordable housing units has been
declining since 1991
In-Kind Benefits
Housing: Programs
• SheltersEmergency; day by day.
Domestic Abuse Shelters- Limited Time
Family Shelters – Limited time
• Public Housing
High-rise or Clustered
Scattered
• Foster Care: Family or Group Homes
In-Kind Benefits
Housing: Programs
• Residential Living- Assisted Living
Supervised independent living
Supervised group homes
Physical and mental disabilities
Senior citizens
• Correctional Settings
Detention Centers and Jails
Correctional treatment centers
Half-way houses
Evidence
Does TANF Work?
Numerous studies of TANF leavers indicate
that the program and its policy (PRWORA)
is more effective in reducing welfare
caseloads than in reducing poverty.
Model Two
The Family As Protector
• As a societal institution, the family is responsible
for meeting the expressive needs of its members
for protection, education, and socialization.
• Societies establish specific family policies (or not)
to support the family as a valued societal
institution.
• The family buffers members from the harsh
realities of their physical and social environments
• The family nurtures it members by providing for
their socio-emotional needs.
Model Two
Family Violence
Factoid
Despite the romanticized view of the family
held by many, individuals are more likely to
be killed, physically assaulted, sexually
victimized, hit, beat-up, slapped, or spanked
in their own homes by other family
members than by anyone else in our society
Model Two
Family Violence: Statistics
• 1400 women are abused every day in the
United States (Roberts and Roberts, 2005)
• Between 3 and 10 million children witness
some form of violence in the home each
year.
• In 2001, an estimated 903,000 children
were victims of abuse and neglect.
Model Two
Definition of Child Maltreatment
• Child maltreatment is defined as a
heterogeneous group of acts (commission or
omission) that place children at risk.
• Child maltreatment- 4 types
(1) physical abuse
(2) child neglect
(3) sexual abuse
(4) emotional abuse
Model Two
Physical Abuse
• Physical Abuse is the infliction of physical injury
by various methods, even if the perpetrator does
not intend harm.
• In the United States, physical punishment is
regarded as a form of physical abuse.
• In Canada, the use of physical punishment is
allowed as a parental form of correction. Workers
must distinguish physical punishment from
physical abuse.
Model Two
Child Neglect
• Child neglect is the failure to provide for
the child’s basic physical, educational,
medical, or emotional needs.
• The inability of parents to adequately
supervise their child(ren) is a form of child
neglect e.g. children in need of supervision
Model Two
Sexual Abuse
• Sexual abuse is the involvement of a child
in any kind of sexual action including
incest, sexual molestation by a family
member, prostitution, pornography, or
human trafficking.
Model TWO
Emotional Abuse
• Emotional abuse is an act or omission that
has caused or could cause serious cognitive,
behavioral, emotional, or mental disorders.
• Some jurisdictions include exposure to
domestic violence under emotional abuse.
Model Two
Structure: Children’s Bureau
• The federal government established the Children’s
Bureau in 1912 because of societal concern over
child labor, delinquency, and orphaned children.
• Title V of the 1935 Social Security Act directed
the bureau to cooperate with states to develop
child welfare services.
• In 1967, child welfare funding under title V
became Title IV-B, Child Welfare Services.
Model Two
Battered Child Syndrome
• Battered child syndrome emerged (1960’s) as a
public issue due to the observation of pediatric
radiologist John Caffey; prior to this injuries to
children were considered a private family matter.
• Between 1962-1965, every state passed legislation
preventing child abuse.
• The Child Abuse Prevention and Treatment Act
(CAPTA) was enacted in 1974. This act was
reauthorized in 2003 as the Keeping Children and
Families Safe Act. P.L. 108-36.
Model Two
Mandatory Reporting
• In the 1970’s laws mandating reports of suspected
child abuse were enacted in every state. See
chapter two on fiduciary responsibilities.
• According to Knoke and Trocme (2005) the
inclusion of exposure to domestic violence as a
category of mandated reporting of child emotional
abuse led to 133% increase in reported cases of
suspected child abuse in Canada.
Model Two
Child Neglect & Abuse: Statistics
• Rates: Child abuse rates are similar in Canada,
England, Australia, and the United States.
• U.S. Reports of suspected abuse: 1970-1974
250,000 child abuse reports annually.
• U.S. Reports of Suspected Abuse FY 2000
2 million reports of suspected abuse and neglect
1.8 million reports were unsubstantiated.
• U.S. Substantiated Reports FY 2000
879,000 children were victims of maltreatment.
Model Two
Conceptual Quagmires: Defining Harm
• The use of physical force against children is
prevalent in the United States. (Gelles and Straus,
1987); Severe physical harm occurs in a minority
of maltreated children (Zuravin, Orme, Heger,
1995).
• Acts (beatings, use of weapons) that have a high
probability of resulting in severe physical harm
requiring medical treatment occur at much lower
frequencies than milder forms of abuse (bruises,
scratches).
Model Two
Child Fatalities
• Some form of physical injury in 28% of the total
number of reported cases in study by (Trocme,
MacMillan, Fallon, Demarco, 2003)
• Minimal harm: a bruise, scratch, or sprain but no
need for medical treatment.
• Severe physical harm occurred in 4% of the
cases.; shaken baby syndrome accounts for the
highest rate of severe harm (Trocme et al 2003)
• U.S. Child Fatalities
FY 2000 –1200 child fatalities
FY 2003 – 1500 child fatalities
Model Two
Defining Harm: Critique 1
• Some critics charge that harm is too narrowly
defined as physical injury requiring medical
attention.
• Such a definition does not take into account
psychological harm associated with living in an
environment where one is physically assaulted
even though such assaults do not require medical
treatment.
• Verbal assaults leave no visible scars but can cause
psychological harm.
Model Two
Defining Harm: Critique 2
• Others argue that many children and families are
unnecessarily subjected to investigative intrusion
that result in unsubstantiated reports.
• In FY 2000 approximately 1.8 millions reports
were unsubstantiated.
• Finally, critics wonder whether families should be
separated where maltreatment has been
substantiated but there is no severe physical harm.
Model Two
Assessing Safety and Risk
Safety: imminent danger – short term decision;
information gathered is more narrowly focused.
Removal of child to protect him/her now.
Risk: potential for re-abuse – long term decision
Probability of future maltreatment: safety and
risk assessments categorize families on the basis
of probability of imminent and future abuse
Service Intensity: Accuracy in assessing risk is
crucial to ensure that appropriate intervention
(type and intensity) is provided.
Model Two
Assessment Tools: Actuarial
• Structured risk assessment. Actuarial
Instrument. Incorporates client characteristics
shown to be statistically predictive of future
maltreatment. Each risk factor is weighted in
terms of its overall risk rating as determined by a
formula designed to maximize accuracy.
• Example: FRANN- the Michigan Structured
Decision Making Systems Family Risk
Assessment of Abuse and Neglect.
Model Two
Assessment Tool: Consensus
• The other type of instrument is based on
consensus. Such instruments are based on expert
clinical judgment. Case files and case vignettes are
used with expert panels to arrive at items thought
to be predictive of future abuse.
• Examples are Washington Risk Assessment Matrix
(WRM) and the California Family Assessment
Factor Analysis (CFAFA).
Model Two
Predicting Future Abuse
• Prediction Accuracy: Regardless of the type of
instrument used, one cannot predict with 100%
accuracy which substantiated cases of child abuse
or neglect will result in severe harm or death.
• Re-entries: How shall they be interpreted?
- indicative of a new problem/crisis
- indicative of chronic/untreated abusive behavior
Model Two
Service Delivery: Intervention Options
• Initial determinations of safety and risk
assist practitioners in deciding upon the
most appropriate intervention: (1)Foster
care: removal of the child from the home
and placement in some form of foster care,
(2) Family preservation: preventing
outplacement through family preservation
services.
Model Two
Protective Service Legislation
• Mandatory Reporting –State laws 1970”s
• Prohibition of child abuse-State laws 1962-1965.
• Federal Legislation: Child Abuse Prevention and
Treatment Act -CAPTA, 1974; Keeping Children
and Families Safe Act, P.L. 108-36, 2003;
• Permanency Planning: Adoption Assistance and
Child Welfare Amendments of 1980 P.L. 96-272 –
Mandated permanency planning within a
reasonable time; effort to counter foster care drift.
Model Two
Protective Service Legislation
• Independent Living Program: Amendment to
title IV-E 1980 to assist youth who age out of
foster care.
• Family Preservation: Title IV-B amended to
create family preservation and family support
programs, 1993.
• Multiethnic Placement Act: 1994
• Interethnic Adoption Provisions 1996
• Adoption and Safe Family Act: 1997
Model Two
Four Principles/Child Protection
1. Permanency planning- timelines for moving
children to permanency in their care
2. Reasonable efforts – States are required to
show that reasonable efforts to keep the child in
his/her family of origin were made prior to
seeking a court order for substitute care.
3. Least restrictive alternative: workers should
attempt to care for children in the least
restrictive environment.
4. In the Child’s Best Interest:
Model Two:
Determining the Child’s Best Interest
Operationally, workers often experience conflict
when determining whether, in a specific case:
(1) family preservation is in the best interest of
the child
(2) temporary foster care & family reunification
is the child’s best interest.
(3) permanency planning through adoption and
kinship care is in the child’s best interest.
Model Two
Foster Care
• Definition: Foster care is defined as 24 hour
substitute care for children outside their
own homes.
• Settings: Foster care settings include:
family foster homes, relative foster homes,
group homes, emergency shelters,
residential facilities, childcare institutions,
and pre-adoptive homes.
Model Two
Foster Care: U.S. Statistics 2001
• Total Number: 542,000 children in foster care
260,000 in non-relative foster care
57% of foster care children were reunited with
parents or a primary caretaker
• Entries and Exits
290,000 entered foster care in FY 2001
263,000 exited foster care in FY 2001
• Homeless Children
12% were placed in foster care
Model Two
Foster Care: U.S. Statistics 2001
• Length of stay
Average length of stay 11.7 months for those
entering care in 2001.
Average length of stay for all those exiting
foster care in FY 2001 was 22.1 months
Average length of stay for all children in
foster care in 2001 was 33 months.
• Average age: 10 years.
Model Two
Foster Care: Safety
• Abuse does occur in foster care.
In 2001, 0.5% of perpetrators of abuse or neglect
were foster parents; this ½ percent represented
5,133 instances of child abuse and neglect.
• Fatalities
Foster care: 8 reported cases 2001
Family preservation 5 yrs: 175 (10.7%)
Family reunification 5 yrs: 2.8%
;
Model Two
Foster Care: Stability
Critique of Stability:
• Children fare as well in stable foster care as those
left in their home.
• Children who experience unstable foster care
(multiple placements) may be at-risk for long term
emotional, cognitive, and social difficulties.
• The quality of foster care homes can be poor,
average, or good. Homes may be approved with
inadequate investigation or may be inadequately
supervised after selected.
Model Two
Kinship Care
• Scope: Kinship care accounts for approximately
50% of all foster care placements.
• Principles of permanency and least restrictive
environment: Kinship care meets these principles
and offers the option of having contact with
biological parents
• Outcomes: (1) fewer placement moves, (2)
greater retention of ties to the child’s biological
family, (3) lower rates of reentry to care.
• Comparatively, 25% of reunified children return
to care after two years.
Model Two
Adoption: Statistics 2001
126,00 children (18%) were available for adoption.
67% were adopted by strangers
23% were adopted by relatives
10% went to live with relatives though not
adopted
For adoption to occur, parental rights must be
surrendered or legally terminated.
Model Two: Family Preservation
Prevention Of Outplacement
• Outplacement is viewed as the option of last
resort.
• Children are at-risk of outplacement due to:
abuse, neglect, delinquency or need for inpatient
psychiatric care.
• Objective of Adoption Assistance and Child
Welfare Act of 1980 P.L. 96-272 was to mandate
that families be kept intact whenever safe and
appropriate ( without risk to the children) and that
children be returned home whenever possible.
Model Two: Family Preservation
Structure
• Following passage of AACWA, over 30
states and their counties implemented
programs that provide family preservation
type services.
• In FY 2000 family preservation programs
served 314,766 children
• In FY 2000, family reunification programs
served 380,507 children.
Model Two: Family Preservation
8 Program Policies and Procedures
1. Eligibility: those families at imminent risk
of having a child removed.
2. In-home service: intervention occurs in
the family’s home; not in an office.
3. Response time: Workers must respond to
a request for service within 24 hours.
4. Service Intensity: Service is intense (5-20
hours per week)
Model Two: Family Preservation
8 Program Policies and Procedures
5.
6.
7.
8.
Small caseloads: 6-8 families per worker.
Length of service: Brief – 4-6 weeks
Worker availability: Available 24/7
Service blend: blend of “hard” services
e.g. additional funds and “soft” services
such as mental health counseling or skills
training in child care,child rearing,
budgeting etc.
Family Preservation
Service Provisions
•
•
•
•
•
•
•
•
•
crisis intervention
auxiliary funding
parenting skills training
in-home emergency caretakers
child care
housing
transportation
teaching/demonstration
worker home visits
Family Preservation
Service Provisions
• in-home counseling
• referral for individual, family and/or group
counseling.
• substance abuse treatment
• mental health treatment
Model Two: Family Preservation
Determining Eligibility
• Families in Acute Crisis: Because of its short
duration, family preservation programs were
intended to help families in an acute crisis. The
goal of the intensive intervention was to resolve
the crisis after which the family would return to its
pre-crisis state of adequate functioning.
• Families in Chronic Crisis: Often families with
chronic dysfunction present in acute crisis.
Resolving the crisis at hand does not prevent the
recurrence of other crises. In such cases the length
of service has been extended to 3,6, or 12 months.
Model Two:
Family Collaboratives
• Frequently located within public housing
communities.
• Work with protective services but tend to
follow post modern principles; especially
those focused on community.
• Rely on grant money.
• Services are not time limited but are
constrained by funding
The Worker-Family Relationship
In Protective Service
• Direct, face-to-face contact between the protective
service worker and recipient of protective services
is often tense and laden with emotions.
• As agents of the State, social workers have a
fiduciary obligation to ensure child safety.
• Historically, protective service workers have relied
on casework and/or case management e.g.
removal, temporary foster care, reunification. .
The Worker-Family Relationship
In Protective Service
• Currently, protective service is conducted within
the context of family preservation, post-modern
principles, and a family strengths perspective
• Though child welfare is a service rather than a
therapy, the DSM IV recognizes, through V-codes
the need for therapy for both the victims and
perpetrators of abuse and neglect.
Critique of Protective Service
Models
• A conceptual quagmire exists in defining harm
• At the operational level, acting in the best interest
of the child and preserving the family are often in
conflict
• Traditional models of providing substitute child
care have led to foster care drift.
• Family preservation and family reunification
models may prevent outplacement but appear to
be associated with higher rates of reentry and child
fatalities.
Critique of Protective Service
Models
• Post-modern principles do not always result in a
shared (worker-family) narrative of what is in the
best interest of the child.
• A family strengths perspective, like more
traditional perspectives, sustains the social order.
It does not challenge the sociological causes of
family dysfunction and gives a pass to inadequate
resources and service delivery.
• Therapy for victim and perpetrator, if offered, is
outsourced.