Visits : Planned, Purposeful and Progressive Rose Wentz rosewentz@comcast 206 323-4394

1. Visits: Planned, Purposeful and Progressive Rose Wentz rosewentz@comcast.net 206 323-4394

2. Definition of Visits • All types of visits (birth parents, siblings, extended families, even pets) • All types of contact (face to face, phone, letters) and all levels of supervision • Unsupervised • Observed/Monitored • Supervised • Therapeutic

3. Federal Laws • Adoption and Safe Families Act • Visits are an indicator that the ASFA reviews have shown to improve the outcomes for children • Permanency • Safety • Well-Being • Visits has been legally defined to be required to meet Reasonable/Active Efforts through appellate court decisions

4. The primary purpose of Visits are? • To assess a parent’s ability to safely parent their child; • To meet the child’s developmental needs; • To be an incentive to encourage the parent to attend treatment; • To determine the final permanency plan.

5. Goal of Visits • The visit allows the child to be safe and that it is held in the most natural and home-like location possible. • Children and parents may feel discomfort before, during or after a visit. A child should not be traumatized by visits. • In some cases “visits” that do • not require face to face contact • may be necessary to ensure • the child’s safety.

6. Children are more resilient when they have multiple healthy connections.Resiliency is the key to surviving trauma.

7. Research • Visits are associated with shorter placements and higher rates of reunification • Worker contact with parents increases their participation in visits • Worker encouragement of parent and non-office locations increase parental attendance • Child’s reactions are the NORM • Regularly scheduled visits increase parental attendance

8. Research • Visits cause parents, caregivers and workers to face their issues and thereby adults often have reactions to visits • Be sure adult reactions/conflicts do not interfere with visits • It is rare that having NO contact with a parent is in the best interest of a child • Children will have contact with parents even after adoption or years of separation

9. Best Practice Standards • Written – case records and court orders • Include all parties in the planning • Make the visit as normal as possible • Consistency in location, time, place, people involved • Within 48 hours of initial placement • Phone call shortly after initial removal • Homelike location • At least weekly • At least one hour in length • Overnight visits before returning a child home • Sibling visits must occur regularly if not living together • Caseworker observers at least one visit each month

10. Four Steps to Developing a Planned, Purposeful and Progressive Visitation Plan • Child Development and Parenting Skills • Type of Abuse or Abuse • Level of Supervision • Time in Care (Concurrent Planning) • Initial Placement • Reasonable Efforts • Final Permanency Decision • Post Permanency • Other Factors

11. Child DevelopmentStep One • The FIRST and PRIMARY purpose is to meet the child’s needs. • Children have many different types of developmental needs: educational, emotional, medical, moral, social and cultural. • If meeting the needs of the adults is in conflict always use the child’s need to determine your plan. • Over 50% of children in foster care have developmental delays. • The goal is to help a child move towards the next developmental milestones. • All children are initially traumatized by the separation from his/her parent. Visits should help a child handle the trauma and catch up on delays.

12. Frequency, Activities, Locations, and Items for a visit From the child’s perspective • How frequently should a child of this age visit with his/her parent? • List the activities that can occur that will enhance parent/child attachment • List the locations that the visits can occur. What location would be best? • List activities that can occur when face to face visits are not possible • List things the child may want to bring or have at a visit (transitional object)

13. Child Development - Infancy Trust vs. Mistrust Stage • Do not understand change • Attachment is critical • Communication limited • Interferes with development • Adults must cope for child • Separation is immediate and permanent

14. Child Development - Toddler Autonomy vs. Shame/Doubt Stage • Regression and Fear • They control the world • Forms attachments to others • Adults must cope for the child • May see foster care as punishment • Must be helped to learn new home • Days = permanency

15. Child Development - Preschooler Identify and Power Stage • Magical thinking • Does not understand cause and effect • Forms attachments to adults and other children • Needs help coping • Self blame – Acting Out Fears • Weeks = permanency

16. Child Development – School Age Industry versus Inferiority Stage • A concrete world • Months are permanent • Self esteem tied to family • Foster child is “different” • Compare parents • Friends are important • Perception may be distorted • Needs to know “rules”

17. Child Development - Adolescent Identify versus Identify Diffusion Stage • Adult understanding • Decision making • Adults as role models • Emotional and body changes • Moral development • Future, emancipation • Ambivalence about family • Help with conflicts

18. Attachment and Bonds • Secure attachment: an exclusive attachment made between children and their contingent, sensitive caregivers, who provide nurture, comfort, buffering, shared exploration, and help. Parents represent a secure base for exploration. • Examples of secure attachment from a child’s point of view are: • My parents come back. They are reliable. • I can depend on my parents and people whom they entrust to educate and spend time with me. • I want to please my parents most of the time. • I am rewarded for being competent, for my curiosity, and for my positive states. • I can get help with psychologically overwhelming events and feelings. • Parents teach me how to cope with problems and to solve them. • Intimacy is enjoyable. • Bonds: Close relationships which tend to be formed with teachers, friends, and others who have shared experiences and emotions. (Gray, 2007)

19. Child feels discomfort Child expresses discomfort Child feels comfortable Parent comforts child (need is met) Attachment and Bonding Arousal Relaxation Cycle

20. Ways to Encourage Attachment • Responding to Arousal/Relaxation Cycle • Using child’s tantrum to encourage attachment • Responding to child when he is physically ill • Helping child express and cope with feelings • Share child’s excitement about her achievement • Initiating Positive Interaction • Making affectionate overtures; hugs, kisses, physical closeness • Reading and playing games with the child • Helping child with homework • Going to fun events together • Saying, “I love you” • Teaching the child about extended family and culture • Claiming Behaviors • Encouraging the child to call parents “mom” and “dad” • Hanging pictures of child in the house • Including child in family rituals • Buying clothes • Involving in religious or rite of passage events

21. Children’s Reaction to Grief and Loss • Separation is always traumatic • Child’s reaction will vary according to her current attachments • Uncertainty hampers a child’s ability to cope • Children who are in trauma stop or regress on their developmental tasks • There are no set patterns of reactions • Yearning is a dominate characteristic

22. Stages of Grief and Loss • Shock • Denial • Anger • Protest • Bargaining • Depression • Resolution

23. Elements of a Visitation Plan • Purpose • Frequency • Length • Location • Who attends • Activities • Supervision • Responsibilities • What to have at the visits

24. Impact of Separation Chart

25. Developing a Visitation Plan

27. Progressive Visitation • Visits usually start as supervised visits with many restrictions on location, activities, etc. • When the parent and child are successfully interacting during visits, the plan should allow for ONE element to be changed at a time. Example: Lengthen the visit or change the location of the visit. Do not change both at the same time. • The goal is to slowly increase the parent’s responsibility and move towards unsupervised visits in the parent’s home while safely testing the parent’s ability. • One change allows for accurate assessment of success or failure. The goal is to always have a safe and successful visit for the child. • When there is a failure or repeated problems go back to the last success visit plan and determine what will make the visit more successful. Try to only change one element at a time even when there has been a problem.

28. Reward and Punishment • Visits are NEVER to be used as a reward or punishment for the parent or the child. • Research shows that doing this does not lead to parents attending treatment. • Children will get the message that relationships are based on having good behaviors and thereby are conditional. • This includes things like: • If you are clean and sober (pass UA) then you get to have a visit. • If you follow the rules of the house you get to have a visit. • When you complete your treatment you will get to have more visits. • If you make your husband move out of the house then you can have unsupervised visits. • Visitation plans are based on behaviors AT the visit!

29. Roles and Responsibilities • BIRTH PARENT • SOCIAL WORKER - person responsible to develop plan • CAREGIVER OF CHILD • CHILD/YOUTH • SUPERVISOR OF VISIT • TRANSPORTER Back of Visitation Plan Matrix TIMES Before During After

30. CherRita • Listen to her experience as it relates to her having visits and contact with her family. • What could have been done to make her experience better and to maintain her connections with her birth family?

31. Types of Abuse – Step Two Pages 18 • The second purpose of visits is to provide the parents with an opportunity to learn new parenting skills or demonstrate safe parenting skills. – REASONABLE/ACTIVE EFFORTS Legal requirements • Skills can be taught during visits or be learned from service providers, family or community. • Visits are one of the few ways of assessing the parent’s FUTURE protective capacities. • The case plan must state the minimum sufficient level of care.

32. Levels of Supervision – all cases A continuum to ensure safety while allowing the most normal family interactions possible. FACTORS IN MAKING THE DECISION • Age of child (ability of the child to self protect) • Type of abuse that the child experienced • Parent’s history of family violence • Potential for abduction of the child • Emotional reactions of the child • Where the visit will occur • Who will be at the visit • Progress parent is making to improve parenting skills • Parental issues such as addiction and mental illness Have agreed upon community Definitions for the levels of supervision.

33. Therapeutic Visits Professional conducts visit to address clinical needs • Sex abuse and extreme forms of other abuse • Parent who is rejecting the child • Child who has extreme fear of parent • Teaching medical or therapeutic care of child

34. Supervised Visits Trained person is within sight and sound of child If the parent is: • Abusive during visits • Inappropriate behaviors by parent • Parent who has not started treatment When child is: • Afraid of parent

35. Observed Visits An objective party is involved or location provides protection • Parent is in treatment but has not completed his/her program • Child expressing discomfort about being left alone • Parent had consistently meet standards during supervised visits

36. Unsupervised Visits No or limited controls needed • Parent has consistently meet standards during observed visits • Parent has made progress in treatment program and/or has a safety plan • Child has a safety plan • Unplanned drop-ins might occur

38. Initial Placement First Day to 30 days in care • Do a visit ASAP no later than 48 hours • Placement should not feel like a punishment • Expect reactions • Confirm that each other is OK • Bring child’s belongings • Supervised • In family home • Do not forget fathers, siblings, and others child have an emotional attachment

39. Reasonable Efforts2 months to 12 months • Child placed with Resource Family – relationship between families • Teaching and demonstrating parenting skills – based on type of abuse • Decreasing supervision • Increasing length and parenting responsibility • Behavior/reactions should be decreasing • Change ONE item at a time • Observation and feedback from Social Worker – 2X monthly

40. Final Permanency Decision12 to 15 months • Overnight if reunification • Limiting if adoption/guardianship • Connections NEVER stop • Reactions to permanent plan may occur • Relationship between families so connections can continue • Prepare child if he must say “Good-bye” • Maintain connections with siblings, friends, school, ethnic group, religion

41. Post PermanencyFrom PP through Life • Child want us to help them maintain connections • Children will look for lost family - and often move in • Siblings is most critical group • Right to know family and history • Help the adults handle their uncomfortableness • Life books • Complete information in case record and with child’s legal family

43. Culturally appropriate visits • All Families have a culture • Children cannot be raised in a culturally neutral manner • Ask the family about their culture and family values • There are many different and successful ways to raise a child • What is something that can be done by a parent on a visit to teach a child their family’s culture?

44. Domestic Violence • Children are impacted by domestic violence even if they do not suffer direct physical harm • Children suffer brain trauma by living in a family that has domestic violence • Professionals must be careful not to blame the victim parent or punish the parent for not leaving his/her battering partner • Special safety precautions must be implemented in these cases

45. Children of Incarcerated and Hospitalized Parents • These children have the need and right to visit their parents. • Visits should not be limited, restricted or non-existent just because of the parent’s living situation. • Children need to maintain and/or resolve their relationship with this parent, even if the parent will be in prison for years or may never be able to care for the child.

46. How To Have A Safe Visit With Addicted Parents • Have a visitation plan that specifically addresses what is allowed and not allowed. • List behaviors that are unsafe or not allowed • State the process of what will occur if parent violates visitation rules • Safety plan - Have a method for the parent to ask for help or ask questions that does not embarrass the parent in front of their child. This plan would include: • resources for the addicted parent to call for help at any time, • resources for an older child to call for help if the parent is not providing safe care, and • family and community members who regularly check on the well-being of the parent and child.

47. ADDICTION • The level of supervision is related to safety and NOT to the progress of drug treatment! • Parents who are sober and/or have completed drug treatment but who cannot maintain safe parenting during visits should NOT be allowed to have their visits progress towards reunification. • Recovery can occur without formal addiction treatment. • Parents who have not completed treatment but consistently maintain sobriety should not be denied a chance to reunify.

48. Mental Illness • Work with parent and therapist to determine how the parent’s illness might impact visits: • Indicators of problems • Medication – how it may affect parent • Treatment plan • Safety plan for parent and child • Older child should be informed of illness

49. Special Needs of Child • Obtain full evaluation of children • Work with treatment provider to determine the child’s developmental age • Develop a plan to help the caregivers help the child achieve developmental milestones • Have the parent involved in treatment and decisions • Use the child’s true developmental age when developing the visitation plan

50. Non-Abusive Parent • What are your fears about this parent? • List an issue on a post it note. • Pass the note to the next table. • What would you do to address those fears?