Family Support Services Research Articles

Effects of Peer Mentoring for Caregivers of Patients With Acquired Brain Injury: A Preliminary Investigation of Efficacy

ObjectiveTo evaluate effectiveness of a peer mentor intervention for caregivers of patients with acquired brain injury (ABI) in encouraging caregiver participation in support services to prepare them for the role of caregiving and in reducing caregiver stress and depression. DesignControlled trial with participants randomized to either usual care or 1-to-1 visits with a family caregiver peer mentor during the ABI inpatient rehabilitation stay. SettingNonprofit rehabilitation hospital specializing in care of persons with brain and spinal cord injury. ParticipantsCaregivers (N=36) of patients with ABI admitted for rehabilitation whose discharge location was home with care provided by family members (caregivers: 93% female; 58% White; mean age, 48±10.4y). InterventionsOne-to-one peer mentoring visits during the inpatient stay with a trained peer mentor who is also a family caregiver of a survivor of brain injury. Main Outcome MeasuresFrequency of participation in support services for family caregivers, reported caregiver stress, and reported caregiver depressive symptoms. ResultsThere was no difference between groups in participation in support services for family caregivers. Participants in the peer mentor intervention group reported significantly greater improvement in caregiver stress at discharge and 30 days post discharge than participants in the usual care group. Reported depressive symptoms were also lower for the intervention group, but change scores did not achieve statistical significance at discharge or 30-day follow-up. ConclusionsPeer mentoring appears to improve caregivers’ ability to handle the stress of caregiving and reduces reported depressive symptoms. There was no between-group difference noted in participation in support services for families; however, participation was adversely affected by restrictions imposed during the coronavirus disease 2019 pandemic, which may have masked any effect.

Met and unmet rehabilitative needs among pediatric patients with moderate to severe TBI

ABSTRACT Objective Estimate the probability of met and unmet post-acute rehabilitative needs among pediatric patients with moderate to severe traumatic brain injury (TBI). Participants One hundred and thirty children who received acute and post-acute rehabilitative services at a hospital for children. Methods Prospective, observational study. Recommended service needs (1. Medical, 2. Psychological, 3. Cognitive/Educational, 4. Medically Based Therapies, 5. Community/Caregiver/Family Support) were collected at discharge and 1, 6, 12, and 18 months post-injury. Probabilities were estimated using nonlinear logistic regression models. The impact of age at discharge was also assessed. Results Over time, the estimated probability of need for Medical, Medically Based Therapies, and Cognitive/Educational services were consistently high. Whereas unmet need for Medical and Medically Based Therapies were low, unmet need for Cognitive/Educational services were relatively high. Need for Psychological and Community/Caregiver/Family Support services increased in the months post-discharge, as did the probability of unmet need. Older age at discharge was associated with need for Psychological and Community/Caregiver Family Support services. Conclusions Findings support the long-term monitoring of need for Psychological and Community/Caregiver/Family Support services among children with moderate to severe TBI. Future research to explore the etiology of unmet needs is warranted.

Mental health and well-being of LGBT+ Veterans dismissed from the British Armed Forces before January 2000

LAY SUMMARY Between 1955 and January 2000, the UK Armed Forces and Ministry of Defence enforced a ban on lesbian, gay, bisexual, transgender, and related (LGBT+) service, dismissing or forcing the immediate retirement of thousands of personnel because of their sexual orientation or gender identity. They fell on hard times and were left isolated and unsupported by the nation they had proudly stood to defend. Although more than 21 years has elapsed since the ban was lifted, little academic literature has explored the ban’s impact on the mental health and well-being of the United Kingdom’s LGBT+ Veteran community. Anecdotal evidence suggests many still endure consequential hardship and mental health struggles and remain isolated from the military family and traditional support services. Fighting With Pride, an LGBT+ military charity launched in January 2020, and Northumbria University’s Veterans and Military Families Research Hub joined in partnership to remedy this by determining mental health and well-being impacts and consequences and identifying recovery pathways. Lived experience narratives must be used to help build support ahead of the publication of any formal findings. Research-based evidence is vital in helping to develop recovery and support policy and in further shaping support services to develop the best possible impact-related outcomes.

Addressing cumulative harm: responding to chronic child maltreatment in the context of an intensive family support service

PurposeAdverse childhood experiences that are consistently experienced over a sustained period of time throughout childhood result in an accumulation of childhood adversity, which is often referred to in the literature as cumulative harm. This paper aims to closely examine statutory child protection practice, which favours an episodic and incident-focused approach to assessing risk and harm, failing to account for the evaluation of the accumulation of adversity and harm, commonly experienced by children exposed to maltreatment. The paper defines an existing gap in practice frameworks to adequately identify and respond to the accumulation of adversity.Design/methodology/approachDrawing on practice experiences in Queensland Australia, the paper examines service delivery responses to cumulative harm in the context of the Intensive Family Support model of service delivery.FindingsWithin current frameworks for child protection service delivery, there is no method of assessing the diverse and cumulative effects of ongoing chronic child maltreatment and adversity, despite research confirming that cumulative harm very often co-occurs with other child protection concerns. To effectively and collaboratively intervene in matters of chronic and cumulative abuse and neglect, practitioners and stakeholders must be guided by frameworks and assessments that accurately recognise and acknowledge the impact of ongoing exposure to adverse experiences and maltreatment.Research limitations/implicationsThe need for a valid and reliable assessment method that draws together all elements contributing to the chronic maltreatment experience for a child and family: multiplicity, diversity and severity.Social implicationsPractice solutions tailored to each child’s specific cumulative experiences of adversity and maltreatment will promote better social, emotional and health outcomes across the lifespan.Originality/valueThis paper highlights a significant gap in assessment and practice frameworks and advances the impetus for cumulative harm to be proactively integrated into social care and service delivery.

INFLUENCE OF FAMILY SUPPORT SERVICES ON EMPLOYEE PRODUCTIVITY: CASE OF SAFARICOM LIMITED, KENYA

Social demands in our world today and pressures from employees have posed a challenging dilemma among employers. The employers have had to adopt strategies that will meet the needs of the employers in order to make sure that they retain the best talents while at the same time provide a work life balance thus ensuring a win-win situation for all parties. Lack of providing work life balances have led to metal ill health related disease, absenteeism to deal with family issues and finally loss of best talent to the competitors especially when they have favorable work life balance practices. The study therefore sought to establish the influence of family support practices on employee productivity Safaricom limited in Kenya. The study adopted spillover theory. The study adopted a descriptive survey with target population of 4972 employees of Safaricom limited Kenya. A sample size of 370 employees of the target population was considered using stratified sampling method. Quantitative data that resulted from this process was analyzed with help of SPSS version 21 and descriptive statistics such as frequencies, mean, percentages and standard deviation. From the findings, family support services significantly influence employee productivity at r=.598 p<0.005. Additionally, the findings concur with the theoretical foundation of the study that adoption of family support services spills over to the attitude and the motivation of the employees which results to increased productivity.
 
 JEL: J10; J24

Moderators and mediators of outcomes of parents with substance use problems: further evaluation of the Parents under Pressure programme.

Background and aimsFamily‐focused interventions can improve family functioning when parents have substance use problems. However, there has been little focus upon potential predictors of change and analysis of mechanisms of change. This study aims to identify mediators and moderators of change in a pragmatic, multi‐site, randomized controlled trial of the Parents under Pressure (PuP) programme, a family‐focused intervention for parents with substance use and other problems, and treatment‐as‐usual (TAU).DesignSecondary analysis of data: multi‐level modelling was used to investigate moderators of treatment outcome; mediation was tested with cross‐lagged models.SettingCommunity‐based family support services in the United Kingdom.ParticipantsParents (n = 100) attending community‐based addiction services with children aged 2.5 years or younger.MeasurementsPredictors of the primary outcome, child abuse potential, were: baseline child age and gender, composite family risk score, parental substance use and parental emotional dysregulation. Mediation was tested across three time‐points with the observed variables parental emotion dysregulation and child abuse potential.FindingsIncreased child age [Z = 2.14, 95% confidence interval (CI) = 0.01, 0.33] at baseline was associated with greater reductions in child abuse potential for PuP programme participants compared with TAU. Poorer parental emotional regulation (Z = 2.48, 95% CI = –2.76, −0.32) was associated with greater reductions in child abuse potential for all participants. Parental substance use (either recent use or primary substance of concern) did not alter any treatment effects on child abuse potential. The mediation analysis showed that PuP produced greater improvements in emotional regulation at post‐treatment (P < 0.001) compared with TAU, which predicted lower child abuse potential at 6‐month follow up (P < 0.05).ConclusionsFor UK parents enrolled in a family‐focused intervention, baseline measurements of higher child age appear to be associated with greater reductions in child abuse potential at 6‐month follow‐up in PuP participants compared with treatment as usual (TAU). Poorer parental emotional regulation and, potentially, higher family risk, appears to be associated with greater reductions in child abuse potential at 6‐month follow‐up in PuP and TAU. Emotional regulation appeared to act as a mediator as improvements in parental emotional regulation post‐treatment appeared to be associated with greater reductions in child abuse potential at 6‐month follow up. Notably, participation in the PuP programme led to better parental emotional regulation compared with TAU.

Clinical and individual features associated with maternal stress inyoung adolescents with autism spectrum disorder.

Parents of people with autism spectrum disorder experience both negative stressful and positive events. Several clinical and socio-demographic features of children on the autism spectrum have been associated with parenting stress in their families. However, there have been few studies that focus on adolescents and the role of cognitive impairment has rarely been addressed. The main aim of the present research is to explore associations between autism symptoms, cognitive impairment, emotional and behavioral problems, socio-demographic features, and maternal stress in a sample of young adolescents with Autism Spectrum Disorder with and without cognitive impairment. Cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Maternal education and occupation are only associated with maternal stress in the group with cognitive impairment, while maternal age is stress-associated in the group of adolescents without cognitive impairment. Age-related implications for intervention and future research directions are discussed. LAY SUMMARY: Parents of individuals on the autism spectrum are exposed to both negative stressful and enriching experiences during their parenthood. While the influence of several child characteristics and socio-demographic features on parental stress during childhood has been widely explored in past studies, studies on teenagers are limited. The aim of the present research is to explore the influence of several characteristics on maternal stress levels in families with teenagers on the autism spectrum. We found that cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Socio-demographic features are not associated with maternal stress. Broadly speaking, the subjective perception of parental distress in both groups is less related to teenagers' characteristics then the perception of having a difficult interaction with the teenagers. We divided our participants into two groups (one group with cognitive impairment and the other group without). We found that mothers of teenagers with cognitive impairment are generally more stressed compared to the other group. Furthermore, we confirm that emotional and behavioral problems seem to play a major role in maternal stress (especially in the group without cognitive impairment), while autism symptoms seem to play a minor role. Furthermore, we found that maternal education/occupation and maternal age are associated with maternal stress in the group with and the group without cognitive impairment respectively. This research highlights the association between several variables and stress in mothers of adolescents on the spectrum. Results are discussed in the framework of previous findings highlighting the lack of adequate care and support services for families, especially for those of adolescents on the spectrum with cognitive impairment.

Social Support from Family and Peers in Elderly as Effort in Improving the Psychological Well-being during Covid-19 Pandemicat Surabaya

Social support is important in improving the health of the elderly. The spread of Covid-19 can reduce thephysical and mental condition of the elderly. The purpose of this study was to analyze the social support offamily and fellow elderly in the elderly as an effort to improve their psychological well-being during theCovid-19 period.This research was a survey research, based on its character, it is an analytical description with a crosssectional design. The population is all elderly in Surabaya and Madura areas.The sample was 305 partlyelderly from 3 cities of Surabaya, Pamekasan, and Sumenep chosen through random sampling technique. Theindependent variable wassocial support, which is the social support from family and friends, while thedependent variable wasthe level of psychological well-being of the elderly. The research instrument indetermining thesocial support from family, the social support from peer and the level of psychological wellbeingwas questionnaire. Meanwhile, the data analysis was conducted by using logistic regression.The results of peer support obtained p = 0.127; Family support obtained p = 0.000;Rsquare was 0.080,indicating that the family social support affected the psychological well-being of the elderly. It is expectedthatthe elderly can improve their health during the Covid-19 pandemic by carrying out positive activities bothat home and in the community. Family support and health services for the elderly are needed in improvingthe psychological well-being of the elderly. Psychological well-being must always be improved so that thehealth of the elderly can be achieved and the elderly can pass through the pandemic well. This requiresgovernment participation and policies to make it happen.

Predictors of Unmet Family Support Service Needs in Families of Children with Special Health Care Needs.

This study describes rates of perceived and unmet need for family support services (care coordination, respite care, and family mental health care) among a national sample of children with special health care needs (CSHCN), distinguishing children with emotional, behavioral, or developmental problems (EBDPs) from children with primarily physical chronic conditions. It also examines if a child having EBDPs is associated with perceived and unmet family support service needs and investigates public versus private health insurance's moderating effect on this association. Using data from the National Survey of Children with Special Health Care Needs (2005/2006 and 2009/2010), this cross-sectional study uses multi-level, fixed effects logistic regression. When compared to CSHCN with no EBDPs, parents of CSHCN with EBDPs report greater need for all family support services and greater rates of unmet need for all support services. This pattern of greater need for CSHCN with EBDPs versus those without is similar among those with public and private health insurance. Among CSHCN with family support needs, however, the pattern differs. For CSHCN with EBDPs, having public insurance is associated with lower probabilities of unmet needs compared to private insurance. For CSHCN without EBDPs, having public insurance has a mixed effect on probability of reporting unmet need. Having EBDPs and public insurance is associated with increased perceived need, but public insurance also confers particular benefit for children with EBDPs.

A Study on Family Support Services for Adults with Developmental Disabilities

본 연구는 A시에 거주하는 만 19세 이상 성인 발달장애인과 동거하는 가족을 대상으로 가족지원 서비스 이용현황 및 개선 방안을 탐색하기 위한 목적으로 설문조사를 실시하였다. 최종적으로 375부의 설문지를 통계처리 하였으며 χ² 검증, 독립표본 t-test, one-way ANOVA를 활용하였고, 사후검증에는 Tukey 방법을 사용하여 분석하였다. 주요한 연구결과는 다음과 같다. 첫째, 성인 발달장애인 가족은 가족지원 서비스로 경제적 지원을 가장 많이 이용하고 있었고, 교육적 지원, 사회적 지원, 정서적지원, 의료&#8901;건강지원 순으로 이용빈도가 높았다. 장애인 가족지원 서비스의 주요 개선사항으로는 ‘시설 수 늘리기’, ‘적합한 서비스 제공’, ‘서비스 질 확대’, ‘서비스 시간 확대’ 등으로 응답했다. 둘째, 장애인 가족의 배경에 따른 가족지원 서비스 만족도는 총소득, 거주지, 가족형태, 동거가족수에 따라 통계적으로 유의한 차이가 나타났다. 셋째, 장애인 가족의 배경에 따른 가족지원 서비스 필요성은 가족형태, 최종학력, 거주지, 총소득에 따라 통계적으로 유의미한 차이가 있었다. 결론적으로 성인 발달장애인 가족지원 서비스 개선 방안으로 서비스 이용 활성화 전략, 성인기 특성 반영 프로그램, 경제적 부담 경감 및 부모 사후 안정된 경제생활 지원체계, 비장애 형제&#8901;자매 가족치료, 조부모 대상 장애 정보 제공, 권역별 서비스 제공기관 확충과 욕구맞춤형 서비스 마련이 제시되었다.

Frontline Workers’ Challenges in Hearing Children’s Voices in Family Support Services

ABSTRACT Research into children’s voices continues to receive significant attention due to the limited progress made around the world in meeting Article 12 of the Convention on the Rights of the Child: the right to be heard and participate in decision making. However, there is a paucity of research providing insights into children’s voices in family support services linked with the child protection system. This paper contributes new understandings into the everyday practice experiences of 46 frontline urban and regional practitioners working in family support services for UnitingCare, a nongovernment organisation in Queensland, Australia. Critical and interpretive research utilising WorldCafé focus groups reveals hearing children’s voices is not occurring as an everyday practice. It identified four intersecting influences that prevent rights-based children’s participation: program, conceptual, organisational, and direct practice issues. A sustained paradigm shift to protection with participation is needed to ensure children’s voices are included as an everyday practice in family support services. IMPLICATIONS Culture, program, organisation, and practice level challenges intersect to impede frontline family support services practitioners from hearing children’s voices as an everyday practice. A paradigm shift to “protection with participation”, a culture that values children and their voices, alongside steadfast leadership are needed to embed a rights-based, child-inclusive approach in family support services as part of the care continuum.

Needs assessment in unmet healthcare and family support services: A survey of caregivers of children and youth with autism spectrum disorder in Delaware.

The study aimed to collect data from families of children and youth with Autism Spectrum Disorder (ASD) in the state of Delaware, USA to understand their ongoing needs and challenges in accessing child healthcare and family support services. We analyzed responses from 263 caregivers of children and youth with ASD from 3 to 24 years using a statewide needs assessment survey. Over 50% caregivers indicated having unmet needs relative to both child/youth healthcare services and family support services. Between 24 and 38% caregivers expressed unmet needs for healthcare services such as social skills training, speech-language therapy, behavioral intervention, and occupational therapy for their child and 20-24% expressed needs for family support services such as respite care, parent/sibling support groups, counseling, and babysitting support. Additionally, number of prior early interventions received, limitations in accessing healthcare services, and unmet needs for family support services significantly predicted child/youth unmet healthcare needs. Greater ASD severity and difficulties accessing child/youth healthcare services predicted participant's functional dependence on caregivers for activities of daily living. Together, these findings call for designing holistic, family-centered interventions that address needs of both children and youth with ASD and their families. LAY SUMMARY: A statewide needs assessment survey of caregivers of children and youth with ASD revealed that 50% responders had unmet needs relative to both child/youth healthcare services and family support services. Number of prior services received, limitations in accessing healthcare, and unmet needs for family support are linked to child/youth unmet healthcare needs. Severity of autism and difficulties accessing child/youth healthcare are associated with participant's functional dependence. Together, these findings call for placing the family at the heart of the service system in ASD.

Social Support and Family Functioning in Chinese Families of Children with Autism Spectrum Disorder.

Families caring for children with autism spectrum disorder (ASD) have reported poorer family functioning. Social support might strengthen family functioning, but limited research to date has focused on this association in China. This study conducted a cross-sectional survey of Chinese families that have children with ASD to examine the relationship between social support and family functioning. Caregivers of children with ASD from Sichuan province in China (N = 167) were surveyed concerning their perceived social support and family functioning. The Social Support Rating Scale was used to investigate caregivers’ perceived social support from three dimensions: subjective support, objective support, and the utilization of support. A Chinese version of the Family Adaptability and Cohesion Scale was used to investigate their perceptions of family cohesion and adaptability. The Pearson correlation coefficient and stepwise multiple regression were used for analyses. The results suggested that social support was positively related to family cohesion and adaptability. Of the three sub-domains of social support, both subjective support and the utilization of support were positively associated with family cohesion and adaptability. The study’s findings evidenced the importance of different types of social support and could be used to develop a targeted support service for families that have children with ASD to improve their family functioning and sustain the family unit.

‘Living in parallel worlds’ – bereaved parents’ experience of family life when a parent with dependent children is at end of life from cancer: A qualitative study

Background: When a parent of dependent children (<18 years old) is at end of life from cancer, this has a profound impact on the family. Children less prepared for the death of a parent are more susceptive to poorer psychosocial adjustment in later life. There is a lack of understanding from the literature surrounding what support parents require, and how they navigate this end of life experience. Aim: To explore bereaved parents’ experience and needs for families when a parent is at end of life from cancer with dependent children. Design: In-depth, semi-structured qualitative interviews were conducted with 21 bereaved mothers and fathers, identified from the general public, a family support service and hospice. Data were analysed thematically. Results: Parents often live in ‘parallel worlds’ throughout the end of life period. In one world, ‘living in the moment’, cherishing the ordinariness of family life, remaining hopeful treatment will prolong life, whilst adapting as the illness unfolds. The other world presents as ‘intermitted glimpses that death is approaching’, shadowed with painful emotional concerns surrounding their children and the future. At the end, death rapidly approaches, characterised as suddenly ‘falling off the cliff’; placing significant demands on the well-parent. Conclusions: Amidst challenges, clinicians should provide parents with clear information surrounding a poor prognosis, so families can plan and prepare for parental death. There is a need for healthcare professionals to engage, encourage and equip parents, as they prepare their children throughout the end of life experience for the inevitable death of a parent.

Why having a voice is important to children who are involved in family support services

BackgroundHaving a voice in family matters is considered a protective factor from harm, and key to promoting children’s wellbeing. However, since the adoption of the United Nations Convention on the Rights of the Child (1989) and specifically Article 12 pertaining to children’s participation, research reveals that children’s voices often remain invisible in child protection and family welfare services. ObjectiveWhile there is renewed interest in hearing children’s voices about their experiences in out-of-home care, there remains little awareness and knowledge of children’s voices in family support services. This article addresses this gap by presenting children’s own meanings and experiences of having a voice, derived from a research collaboration between UnitingCare and Queensland University of Technology . Participants and setting17 children aged 6–16 years (8 sibling groups) whose families received family support services (voluntary or ordered) from UnitingCare in Queensland, Australia. MethodsAn interpretative phenomenological approach with activity-based interviews involving art, play and Reflexions cards were used to support children to share their lived experiences. FindingsChildren’s sense-making related to having a voice revealed four connected meanings that poignantly illustrated that not only should children have a say about the supports they receive because they are part of a family, but because they are knowledgeable agents with insights that can improve their and their family’s experiences. ConclusionFamily support services need a sustained paradigm shift towards protection with participation to incorporate the voices of children as an everyday practice to ensure their wellbeing and safety.

The role of mentalization in child psychotherapy, interpersonal trauma, and recovery: A scoping review.

Children who are exposed to trauma often develop difficulties with reflective functioning, affect, and emotion regulation. These problems are thought to arise from and are reflective of disruptions in the process of mentalization, or the human capacity to interpret and reflect upon the thoughts, feelings, wishes, and intentions of oneself and others. This scoping review sought to describe the empirical support for focusing on mentalization processes in psychotherapy for children who have been exposed to trauma. Two independent researchers searched electronic databases, Psychology and Behavioral Sciences Collection, MEDLINE, PsycARTICLES, PsycINFO, and Cochrane. Search terms child, trauma, mentalization and mentalization-based therapy were applied. A total of 425 studies were screened against the inclusion criteria, to include 18 studies comprising quasi-experimental, cross-sectional, naturalistic, case-control, and case studies. In all, 3 themes were identified across the articles: (a) trauma and mentalization, (b) measurement of mentalization, and (c) charting recovery. The literature suggests the role of mentalization treatment in the remission of symptoms for internalizing and externalizing disorders and shaping mentalization deficits over time. Mentalization focused treatments may also improve reflective functioning, emotional regulation capacity and the quality of attachment. The implementation of a child mentalization-based model as a preventative intervention may contribute to increased positive outcomes for vulnerable children. This scoping review presents an overview of the evidence for program developers, mental health services, family support services and those in independent practice that wish to adopt a mentalization approach in child psychotherapy. Future systematic reviews are needed to support this evidence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Faktor Eksternal Yang Berhubungan Dengan Minat Ibu Melakukan Kunjungan Ke Posyandu

Posyandu is useful for empowering the community and providing easy access to basic health services. The purpose of this study was to determine external factors related to maternal interest in visiting posyandu (a study in the village of Labuh Baru timur). This type of research is an observational analytic study with a cross-sectional study approach design, namely data collection and results are carried out at one time, the data collection technique is carried out using stratified random sampling where the sample of this study is some of the mothers who have children under five in the village area. Labuh Baru Timur. The instruments used in data collection were questionnaires and analysis used univariate and bivariate with the help of the SPSS Version 16.0 program. The results of research conducted by researchers from March to April 2020 with the title of external factors related to maternal interest in visiting posyandu show that there is no relationship between distance to posyandu, family support, and posyandu service services with maternal interest in visiting posyandu which is proven by p-value&gt; 0.05, which is arranged in sequence 0.931 and OR 1, 046; 0.945 and OR 0.959; 0.768 and OR 0.842. Based on the results of this study, it can be concluded that there is no relationship between distance to posyandu, family support, and posyandu services with mothers' interest in visiting posyandu. It is hoped that mothers in East Labuh Baru Village can further increase visits to posyandu in order to improve the health and development of toddlers.

Family Support and the Media in Ireland: Newspaper Content Analysis 2014–2017

ABSTRACT The objective of this paper is to inform a critical analysis of how the media portray family support in Ireland. Findings of a content analysis carried out on national and regional Irish newspapers between 2014 and 2017 are presented which describe communication about family support services provided by Tusla—Child and Family Agency. Results show that even though child protection was not used as a specific search term, news items on the Child and Family Agency and family support were usually focused on child protection and children in care. Results also show that family support activities are reported more positively in local papers compared to national papers. In the discussion, we argue that these findings are important as the media plays an important role in how the public understand, view, and engage with integrated child protection and welfare systems. We consider the implications of the research and advocate working with the media to inform their interpretation and understanding of family support. We suggest this is important as the manner in which the media communicate and frame family support as part of the overall child protection and welfare system is one of the main influences on public understandings and awareness of preventative family support and child welfare services.

Family Support Services in the Context of Child Care Reform: Perspectives of Ghanaian Social Workers

Family Support Services in the Context of Child Care Reform: Perspectives of Ghanaian Social Workers

Abusive Policies: How the American Child Welfare System Lost Its Way by Mical Raz

Reviewed by: Abusive Policies: How the American Child Welfare System Lost Its Way by Mical Raz Paul M. Renfro Abusive Policies: How the American Child Welfare System Lost Its Way. By Mical Raz. Chapel Hill: University of North Carolina Press, 2020. xvi + 162 pp. Paper $26.95, cloth $95. A mid the satanic ritual abuse panic of the 1980s, congresswoman Patricia Schroeder (D-Colorado) explained why such scares resonate with the American public. "You don't need to convince people that child abuse is bad," she proclaimed (114). Indeed, efforts intended to stamp out child abuse remain virtually unassailable. Yet, as historian Mical Raz illustrates in her terrific new book, understandings of child abuse—and thus the measures enacted to limit such abuse—have changed dramatically over the past half century or so. Abusive Policies explores the politics of child abuse from the late 1960s through the present, arguing that definitions of child abuse, neglect, and exploitation have expanded in the intervening years, while state and private mechanisms designed to curb abuse have grown more extensive, coercive, and punitive. Children and families of color, as well as poor and working-class families, have borne the brunt of these transformations, Raz shows, even as the racial, gender, and economic inequalities that enable and exacerbate child abuse remain largely unaddressed by the state and its private auxiliaries. Raz's story begins with the establishment in 1969 of Parents Anonymous, "a self-help group for parents who either abused or were concerned they might abuse their children." Originally called Mothers Anonymous—in keeping with the larger political and cultural "belief that mothers posed the greatest danger to their children"—Parents Anonymous "played a pivotal role in changing perceptions of child abuse" in the United States (9, 40). Specifically, Parents Anonymous helped shape the discourse surrounding the Child Abuse Prevention and Treatment Act (CAPTA). Signed into law in 1974, CAPTA "intentionally circumvented discussions of race and class" by "presenting child abuse as a scourge of all walks of society" (10, 11). As appealing as this framing might have been—particularly during the "post-civil rights" moment in which CAPTA passed—the act disregarded research that proved "that child abuse was more common in low-income families" and also foreclosed more robust, redistributive policy solutions (11). Raz reveals how such "social welfare" approaches—touted by researchers and advocates cognizant of the ways in which "poverty and social inequities" [End Page 317] precipitated child abuse—ultimately went "unheeded by politicians and policymakers" (32). These elite actors opted instead for ostensibly race- and class-neutral child abuse measures, a decision that reflected not only public skepticism of anti-poverty initiatives but also the increasing pathologization of poverty and crime, including the offense of child abuse. While supposedly race- and class-neutral, mandatory child abuse reporting requirements—which proliferated in the mid-to-late 1970s—"led to significant increases in reporting of low-income and minority families," even though "only a fraction of the[se] reports involved physical harm to children" (62). Many of these reports stemmed from alleged incidents of emotional or verbal harm, a consequence of the expanding definition of child abuse in the twentieth century's second half. This surge in reporting also prompted more muscular, more coercive, and more consistent state interventions in the lives of poor and working-class children and families, disproportionately those of color. These interventions often resulted in the criminalization of family members, the removal of children from familial and extended kinship networks, and the placement of children in foster homes. Further, such interventions offered little in the way of material support or other services for needy children and families. As Raz describes the situation in New York City in the late 1970s and early 1980s, "Foster care placement involved taking children from suboptimal homes that could have benefited from further support and placing them in homes where there was a greater danger of physical abuse and death" (84). Indeed, the placement of poor and working-class children in public foster care became increasingly common just as the foster care system desegregated and just as public assistance mechanisms grew more punitive and less generous, as scholars like Julilly Kohler-Hausmann...