Identifying families with complex needs after an initial child abuse investigation: A comparison of demographics and needs related to domestic violence,mental health,and substance use

Families with complex needs related to domestic violence, mental health, and substance use have some of the worst child protective services (CPS) outcomes. Although many of these families are identified during a CPS investigation and subsequently referred to home-based postinvestigation services (HBPS), many are re-reported to CPS, so it is important to understand the postinvestigation experiences of this vulnerable group. Therefore, this study compared families with and without complex needs to understand their uniquedemographics, needs, and postinvestigation outcomes.The sample consisted of 2008 caregivers who received HBPS following an initial CPS investigation. The Family Assessment Form (FAF) was used to measure family functioning in eight domains using a 1–5 scale with higher ratings representing worse functioning. Complex needs were indicated by a mean FAF score of 3 or higher for either domestic violence, mental health, or substance use. Using Pearson chi-square analyses and two-sample t-tests, comparisons were made between families with (n = 836) and without (n = 1172) complex needs. Half of caregivers with complex needs had a history of abuse, 25% had three to five needs, and nearly half had six to eight needs; 90% of caregivers without complex needs had zero to two needs. Furthermore, caregivers with complex needs had higher mean scores for concrete, educational, and clinical needs. These findings highlight the importance of recognizing variation among families referred to HBPS and accurate screening to ensure that families with complex needs are offered and receive services matched to their unique characteristics and needs.     

Widening Our Global View: The Development of Career Counseling Services for International Students

The increased number of international students in United States universities and colleges have created the need for the development of services that appropriately reflect their needs and characteristics. The Career Center at the University of Missouri, Columbia reacted to this phenomenon by developing career services exclusively for international students. Career services are provided as individual services and online services, and consist of information on graduate schools and entrance examination practices, information on available employment opportunities and work permit policies, career assessments, and information about specific skills for obtaining a job in the United States. Several marketing strategies were used to ensure international students' use of services. Important points in developing career services for international students are presented.     

Delivering social work services in collaboration with the legal representation for individual clients: An effective,ethical and economical approach to supporting families in child abuse and neglect legal proceedings

This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation.     

Professional roles and responsibilities in meeting the needs of children with speech,language and communication needs: joint working between educational psychologists and speech and language therapists

There is a large population of children with speech, language and communication needs who have additional special educational needs (SEN). Whilst professional collaboration between education and health professionals is recommended to ensure an integrated delivery of statutory services for this population of children, formal frameworks should be developed for the exchange of information during identification and assessment of needs and planning of intervention strategies. In this study an audit was carried out to examine practical and conceptual issues which might arise in a piloted communication system between educational psychologists and speech and language therapists. Whilst it was found that 62.8% of newly referred children with SEN had some history of co‐existing communication and education needs, it was shown that duplication of work exists and communication is onerous. It was also shown that schools were not fully informed about children’s needs. Joint commissioning of services is required to facilitate individual practitioners in collaborating to serve the needs of these children.     

Hearing parents and deaf children. Some perspectives on sign communication and service delivery.

The results of a survey of hearing parents' perceptions of their use of sign communication with their deaf children are reported. Survey questions addressed parental understanding and motivation in choosing a particular system of sign communication, input from professionals and deaf adults that was found to be most and least helpful, and parental assessment of their service needs. The results of the survey highlight the need for family focused services throughout the deaf child's development, and the discussion includes specific comments made by parents.     

A review of interventions for adolescents with insomnia and the role of the educational and child psychologist: when sleep does not come easily

The role of an educational and child psychologist involves the promotion of mental health and wellbeing. While adolescents who have insomnia are usually referred to Primary Healthcare services, it might be argued that insomnia can be seen as a barometer of psychological wellbeing and should warrant a psychological intervention. A search of PSYCHINFO and Medline revealed that interventions carried out thus far with adolescents who have difficulty initiating and/or maintaining quality sleep include Sleep Hygiene and Sleep Education, Cognitive Behavioural and Multi Component interventions. In this review it will be posited that using multi-modal approaches which are tailored to specific needs may have the most positive outcomes in the treatment of insomnia, by helping adolescents to develop a sense of self-efficacy and emotional regulation in the context of family and peer support. Educational and child psychologists are ideally placed to offer this type of input to adolescents with insomnia.     

A Framework for School Safety and Risk Management: Results From a Study of 18 Targeted School Shooters

Targeted violence continues to pose a threat to school safety. Reported here are the results of a study of 18 cases of school shooters from 1996 to 2012. Variables examined are individual factors and behaviors, family dynamics, and triggering events. Results indicate the need for expanded school-based mental health services, threat assessment, and prevention programming to meet the needs of students at risk of violence. Recommendations for implementing services are included.     

Why screen newborns for cocaine: service patterns and social outcomes at age one year.

OBJECTIVE: To compare baseline characteristics, service provision, and child placement for infants exposed to cocaine in utero based on postnatal screening results. METHODS: We studied a retrospective cohort of 40 consecutive drug-exposed, but seemingly healthy term infants who underwent urine drug screening in the newborn nursery of a community hospital. Using clinical and service agency data, two cocaine-exposed cohorts were compared (a) screen-positive at birth (n = 22) versus (b) screen-negative at birth (n = 18). RESULTS: Both cocaine-exposed groups had similar infant birth weights, levels of paternal involvement, maternal ages, gravidity, parity, and lengths of gestation. Mothers in both groups had similar histories of prostitution, poor home environment, drug use, and prenatal drug rehabilitation. Mothers of screen-positive infants were more likely than mothers of screen-negative infants to have other children in foster care (27% vs. 6%, p = .07), to have experienced previous interventions by child protective services (CPS) (55% vs. 17%, p < .01), to have had no prenatal care (32% vs. 6%, p = .09), and fewer prenatal visits (4.7 vs. 8.6, p = .02). Compared to screen-negative infants, more screen-positive infants were referred to a high-risk infant tracking program (91% vs. 6%), referred to CPS (100% vs. 33%), placed outside the mother's home (50% vs. 22%), and had their mothers referred to drug rehabilitation (36% vs. 11%), (p < .01 for each). By 1 year of age, support services differed little between exposed cohorts. However, 6 of 22 screen-positive infants were in foster care and 3 were placed for adoption, while only 1 of the 18 screen-negative infants was in foster care and only 1 had been placed for adoption. There were no services available in this community to provide coordinated or comprehensive services or drug treatment specific to the needs of drug using mothers and drug exposed infants. CONCLUSIONS: Despite similarities between cocaine-exposed infants cared for in a normal newborn setting (with and without positive urine drug screens at birth), differences in referral services were noted. More striking than these differences was that services for families with drug-exposed infants are inadequate to even meet the needs of those families in our setting deemed to be at highest risk. Neonatal drug screening needs to be paired with effective services.     

Support Needs of Expectant Mothers and Fathers: A Qualitative Study

The aim of this study was to describe expectant mothers’ and fathers’ perceived needs of support during pregnancy. Twenty-two women and 10 men were interviewed in four focus groups and 13 individual interviews. Systematic text condensation was performed to analyze the data. Parents described not only a broad spectrum of social support needs but also needs of psychological and physical support. They also requested to share their experiences with others. The foci of care and parents’ needs of support are more harmonized with medical support than with psychological and emotional support. Mothers’ needs were predominately addressed in the health services, but fathers often felt “invisible.” Antenatal services may need to offer more customized individual support and emphasize peer support in groups; the challenge is to involve both parents through communication and encouragement so they can support each other.     

Predictors of placement for children who initially remained in their homes after an investigation for abuse or neglect

Objective

To examine the frequency and predictors of out-of-home placement in a 30-month follow-up for a nationally representative sample of children investigated for a report of maltreatment who remained in their homes following the index child welfare report.

Methods

Data came from the National Survey of Child and Adolescent Well-being (NSCAW), a 3-year longitudinal study of 5,501 youth 0-14 years old referred to child welfare agencies for potential maltreatment between 10/1999 and 12/2000. These analyses focused on the children who had not been placed out-of-home at the baseline interview and examined child, family and case characteristics as predictors of subsequent out-of-home placement. Weighted logistic regression models were used to determine which baseline characteristics were related to out-of-home placement in the follow-up.

Results

For the total study sample, predictors of placement in the 30-month follow-up period included elevated Conflict Tactics Scale scores, prior history of child welfare involvement, high family risk scores and caseworkers’ assessment of likelihood of re-report without receipt of services. Higher family income was protective. For children without any prior child welfare history (incident cases), younger children, low family income and a high family risk score were strongly related to subsequent placement but receipt of services and case workers’ assessments were not.

Conclusions/practice implications

Family risk variables are strongly related to out-of-home placement in a 30-month follow-up, but receipt of child welfare services is not related to further placements. Considering family risk factors and income, 25% of the children who lived in poor families, with high family risk scores, were subsequently placed out-of-home, even among children in families who received child welfare services. Given that relevant evidence-based interventions are available for these families, more widespread tests of their use should be explored to understand whether their use could make a substantial difference in the lives of vulnerable children.     

An evaluation of key working for families of children and young people with special educational needs and disabilities

Key working is a way of supporting children and young people with special educational needs and disabilities (SEND) and their families, and is highly regarded by families and practitioners. However, there is a lack of up‐to‐date research exploring key working in the current context of policy reforms in England. This article reports an evaluation of key working in four sites in England, with a particular focus on the SEND policy reforms. Key working resulted in a number of positive outcomes for children and young people, families and services, including helping services to meet the requirements of the SEND reforms. Challenging aspects included managing transitions and the relationship between key working practitioner and family, but successful strategies were identified. Key working supports the implementation of specific aspects of the English SEND reforms along with more general cultural change in services to align with families' needs and well‐established aspects of good practice.     

Working With Grandparent-Headed Families in Schools: School Professionals' Perspectives

This qualitative study explores the experiences of school professionals working with grandparent-headed families. Twenty individual interviews with an array of professional school staff were conducted. Thematic analysis was utilized, and 3 key themes emerged: (a) compassion for grandparent-headed families' unique challenges; (b) lack of adequate knowledge about grandparent-headed families; and (c) strategies for engaging grandparents raising their grandchildren. Implications address the importance of understanding the unique needs of grandparent-headed families and ways to maximize the success of these marginalized families through active family engagement and school-linked services.     

To learn and to construct knowledge in the context of work with adult education: a Portuguese case study

Work contexts are frequently referred to as spaces of learning and production of individual and/or collective knowledge. In such contexts specific dynamics are developed which cause the processes of learning and of knowledge production to have particularities. This paper aims at accounting for some dynamics that are associated with those processes, based on the main results of an ethnographic study on the adult educator team of a Portuguese local development association. The research identified ways of working/action rules based on the learning and knowledge production processes in the association. Mutual help, the reformulation and collectivization of practice, reflection in and about the action, and the negotiation of meaning about the practice are some of the mechanisms identified. The study also highlights how those dynamics of knowledge and learning and ways of doing may contribute to a practice which is closer to the needs of the adults to whom this team offers its education and training services.     

Professional skills, concerns, and perceived importance of work with families in early intervention.

Innovations brought about by Public Law 99-457 require early intervention personnel to expand their work practices to involve and support families in the provision of early intervention services. To support training needs in this area, and to understand possible barriers to change, this study examined the extent to which 142 early interventionists from two states felt competent in working with families, valued family roles, and were concerned about changing to family-centered practices. Relationships among these characteristics and experience, discipline, and job category were explored. In general, nurses and social workers scored higher than did educators and other health-care professionals on several dimensions of family-centered care. Many professionals expressed concerns about collaboration.     

National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples.

We compared parent-reported problems and competencies for national samples of 2,600 4-16-year-olds assessed at intake into mental health services and 2,600 demographically matched nonreferred children assessed in a home interview survey. Parents responded to the ACQ Behavior Checklist, which includes 23 competence items, three competence scales, 216 problem items, eight syndrome scales, Internalizing, Externalizing, and total competence and problem scores. Most items and scales discriminated significantly (p less than .01) between referred and nonreferred samples. There were important sex and age differences in problem patterns, but regional and ethnic differences were minimal. Somewhat more problems and fewer competencies were reported for lower- than upper-socioeconomic-status children. Referral rates were similar in the most urban and rural areas, but they were significantly higher in areas of intermediate urbanization. Correlations of problem scores with those obtained 10 years earlier in a regional survey and with surveys in other countries showed considerable consistency in the rank order of prevalence rates among specific problems. Apparently owing to its more differentiated response scales, the ACQ was susceptible to respondent characteristics that reduced its discriminative power below that of the Child Behavior Checklist. Comparisons of procedures for discriminating between the normal and the clinical range supported the value of a borderline category for children who are neither clearly normal nor clearly deviant. Interview data from the survey sample yielded significantly higher ACQ problem scores for children who had fewer related adults in their homes, those who had more unrelated adults in their homes, those whose biological parents were unmarried, separated, or divorced, those whose families received public assistance, and those whose household or family members had received mental health services. Children who scored higher on Externalizing than Internalizing problems tended to have unmarried, separated, or divorced parents and to come from families receiving public assistance. However, among children whose household or family members had received mental health services, there were greater proportions of both Externalizing and Internalizing patterns than among other children.     

Key workers and schools: meeting the needs of children and young people with disabilities

Across the world countries are advocating the education of children and young people with disabilities in mainstream schools. There is also increasing interest in developing effective coordination of the specialist services pupils with disabilities receive from different agencies. This is accompanied by growing recognition that such care coordination can positively influence the experience of inclusion for children and their families. However, while the literature of care coordination generally includes education as a core provider, there is little evidence on involvement of education professionals and the outcomes for children and schools. These issues are addressed by the findings reported here on the role of key workers in care coordination and their relationship with schools. The findings draw on interviews with professionals from seven key worker services across England and Wales, parents and carers who were recipients of these services and teachers in schools serving children supported by key workers. These interviews are part of a wider multi‐method study exploring the effectiveness and costs of different models of key worker services for disabled children. The data reveal the range of education and school issues addressed by key workers and the factors influencing their work with teachers. The benefits for children, families and schools of key worker involvement are identified and the implications for schools explored. Consideration is also given to the advantages and disadvantages of teachers themselves taking on the role of key workers. It is argued that key workers can improve home–school relationships, facilitate the contribution of teachers in inter‐agency working, enable mainstream schools to better meet the individual needs of pupils with disabilities and improve their inclusive practice.     

A pilot study of early childhood mental health consultation for children with behavioral problems in preschool

This study reports the findings of a pilot demonstration project called Together for Kids, which used a mental health consultation model to address the needs of young children with challenging behaviors who are identified in preschool classrooms. The study was conducted in four preschool programs and one Head Start program serving children ages 3–5, including both private-pay families and those using public subsidies. Rates of significant behavior problems as assessed by preschool teachers using a standardized scale were high, with 34% of all children enrolled in preschool classrooms in these sites over a 3-year period identified at-risk of externalizing or internalizing problems. Classroom teachers, as well as individual children and families identified as at-risk, were provided services, including, classroom observation and teacher training, individual child assessment and therapy, family assessment and support, and referrals for other family needs. Analysis of outcomes for 47 children and families with externalizing behavior problems who received individualized consultation, compared to 89 control children, and analysis of outcomes of a matched group of 19 intervention and 19 control children, revealed that the intervention was associated with significant improvements in classroom aggressive and maladaptive behavior, and growth in adaptive behavior. Improvements in child behavior were associated with total hours of individual child services provided, and with improvements in child developmental skills. Significant reductions in the rate of children suspended or terminated from child care programs were also found. Implications for further development of models of early childhood mental health consultation are discussed.     

A co-creation shift in learning management: work design for institutional commitment and personal growth

Some higher education management departments have started to implement customer service orientation strategies in their marketing activities in order to solidify value exchange perceptions, differentiate themselves, and improve retention rates. However, if students are to get the most out of their academic experiences, they need to become meaningfully and psychologically involved in their studies. This research study explored the specific job context of students within the higher education environment by testing the structure of the “work of students” by utilizing job design theories. The ensuing conceptual Student Engagement Work Design Model (SEWDM) and the empirical findings provide a roadmap of how the engagement elements of autonomy, feedback, skill variety, task identity, and customer services can be utilized by universities when attempting to predict institutional commitment and personal growth needs. A co-creation approach to management education is definitely more complicated to promote and implement, but it has the larger payback as costs can be lowered through the careful design of the students’ work so it will be motivational—with students helping to create a better educational experience for their peers, the faculty, and the community resulting in more positive word-of-mouth promotions.