The Child Protection System:

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

2. Amasaganalu

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

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

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

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

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

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

9. Ecological Perspective • Person-in-environment

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

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

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

14. PhysiologicalNeeds Basic Human Needs • Food • Air • Water • Clothing • Sex

15. Safety Needs Safety and Security • Protection • Stability • Pain Avoidance • Routine/Order

16. Social Needs Love and Belonging • Attachment • Affection • Acceptance • Inclusion

17. Esteem Needs Esteem • Self-Respect • Self-Esteem • Respected by Others

18. Developmental Perspective • Types of Development • Physical • Cognitive • Psychological • Social • Emotional • Stages of Development

19. The Child Protection System • Goals • Beliefs • Model

20. Goals • Safety • Permanency • Wellbeing

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

45. Phases of Family Intervention Evaluation Implementing Planning Assessment Joining

46. Joining

47. Professional conversations and personal conversations: What are the differences?

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

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

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