The interventions discussed in one section may therefore be relevant in other sections of the chapter and to interventions discussed in the chapters on legal and health care interventions.
Research points to the interaction of multiple factors in the maltreatment of children; the interaction of these factors has been described in a variety of theoretical models that have evolved over the past decade National Research Council, a,b. Current models include a the ecological models of Belsky and Garbarino, based on the original conceptions of Ure Bronfenbrenner Belsky, ; Garbarino, ; b the transitional model, which regards child maltreatment and maladaptive parenting as extreme ends of a continuum of interactions among social and cultural forces, parenting roles, and individual behavior Wolfe, , ; and c the transactional model of Cicchetti Cicchetti and Carlson, , based on Sameroff and Chandler's formulations, which focus on interactions among risk and protective factors in the social environment of the family.
All three approaches share underlying assumptions that individual characteristics of the child or parent are insufficient to explain the nature and emergence of child maltreatment; each group of models uses a different set of assumptions to examine the interactive processes, perceptions, stresses, and social supports in the family environment. Theorists have considered specific factors that appear to play a significant role in the different models: social isolation DePanfilis, ; Kennedy, ; Ammerman, , stress Fanshel et al.
The Ofsted Interview: ‘Children and families need consistency of social worker’
Three decades of research and practice have shifted the focus of treatment and prevention interventions away from models based solely on individual pathology toward broader social ecological models, with a new emphasis on the social context of parent-child relationships Wolfe, Although the focus of concern is the child victim, interventions in this area often target the parent usually the mother , under the assumption that behavior change in the parent will protect the child.
Such activities include parent support groups, parent education, home visiting, mental health, and other concrete social support and therapeutic services. Programs targeting children include skill-building around resistance to maltreatment, conflict management skills, and therapeutic interventions. Table lists some major outcomes expected from social service interventions, many of which lack reliable measures. Most treatment and prevention interventions do not include data related to child maltreatment as an outcome measure, and those that do usually rely on reports of child abuse and neglect rather than observations of parent-child interactions.
Many of the outcomes highlighted in the table are interrelated; any single intervention may have several intended outcomes for parents, for children, or for both. The relationships among outcomes, such as changes in mental health,. Improved parenting skills, knowledge of child development, and more realistic expectations for child behavior.
Changes in cognitive or social skills may or may not be accompanied by behavioral changes such as use of community resources ; both are thought to be highly influenced by social context and cultural forces. For example, individuals are unlikely to seek out formal or informal services that have consistently been unavailable or unreliable in their family networks or neighborhoods.
Six social service interventions for child maltreatment are reviewed in the sections that follow: 1 parenting practices and family support services, 2 school-based sexual abuse prevention, 3 child protective services investigation and casework, 4 intensive family preservation services, 5 child placement services, and 6 individualized service programs. The sections are keyed to the appendix tables that appear at the end of the chapter.
Researchers have suggested that families who are socially isolated and lack social support may be more prone to neglect than matched comparison samples Belsky, , ; Belsky and Vondra, ; Bronfenbrenner ; Cicchetti, ; Rizley and Cicchetti, ; Thompson, , ; Wolfe, , A number of strategies for intervention have been described and evaluated in the research literature, including 1 individual social support interventions, such as lay counseling, in-home education and parent aide programs, and parent education support group interventions; 2 multiservice interventions that match services to the specific needs of families; 3 risk assessment interventions that assess the strength of the family social support systems; 4 social skills training that seeks to improve a family's ability to gain access to appropriate resources and services see Table ; and 5 intensive family preservation services, which provide family support counseling and referrals during periods of crisis.
These interventions are discussed below in terms of what is known about the outcomes associated with different strategies. Another strategy for preventive intervention, the home visitation program, is usually administered by public health departments and is discussed in Chapter 6 in our review of health care interventions. Variations in the selection of relevant outcomes as well as differences in the service and evaluation designs make it difficult to compare the results of social service interventions in the area of child maltreatment.
There is a lack of consensus about the definition of neglect Dubowitz et al. Most of the evaluations in this area use relatively limited sample sizes, and few have control group comparisons DePanfilis, The variety of outcomes measured includes maltreatment and placement rates, client motivation to change neglecting conditions, childrearing practices, parents' personal care, and child outcomes in domains such as cognitive, language, verbal, and social skills DePanfilis, Although reducing child maltreatment is the ultimate goal for most interventions, proxy outcomes, such as measures of improved child health and emotional and social adjustment, are often used to measure an intervention's effectiveness.
Official reports of child abuse and neglect are often viewed as unreliable indicators, because incidents may not be reported to authorities, or may be falsely reported, or because surveillance bias may affect reports in treatment families who are in close contact with social services programs. In addition, variations in the components, duration, and intensity of treatment services and the length of follow-up periods confound efforts to identify particularly promising interventions.
Controlled designs of multiservice interventions. Used to evaluate the quantity and quality of a family's linkages with formal and informal supportive resources outside the family system. Each model is structured somewhat differently, but all seek to identify intervention targets for strengthening the social network of families. Operates from a family empowerment philosophy and includes multiple types of social support mixed with professional interventions. Services may include casework services, support groups, parent training, support by lay therapists or parent aides, memberships in recreational centers, transportation, and homemaker services.
Individually planned service mixes seek to match services to the specific needs of families. Offer information and role modeling as well as social support to impoverished families. Parent groups provide information on basic child care skills, problem solving, home management, and social interaction skills. Seeks to increase the effectiveness of other interventions geared to serve specific social support functions. Researchers have suggested that neglectful parents are often handicapped by a lack of social skills that might enable them to utilize community support services.
Table 4A-1 lists 15 evaluations on increasing social support that meet the committee's criteria for inclusion. The table includes studies that examine parenting education and social support interventions for families that experience. Reduced reported maltreatment.
Three quasi-experimental evaluations with reports of child maltreatment as an outcome measure indicate no statistically significant difference in the rate of reports of abuse and neglect for experimental versus comparison groups following treatment Barth et al. Some evaluators have used the standardized Child Abuse Potential Inventory CAPI as a proxy outcome to assess the likelihood that parents will abuse their children again.
Two evaluations of the Child Parent Enrichment Project, for example, found that treatment-group parents had significantly lower CAPI scores post-treatment, relative to pretreatment and relative to control parents Barth et al. Parental competence and skills. Another outcome thought to enhance child well-being is improved parental competence. Seven of nine studies testing gains in parenting competence indicate positive effects of interventions to reduce child neglect Burch and Mohr, ; Egan, ; Gaudin et al.
One study did not find enhanced parenting skills in treatment groups relative to comparison groups Resnick, A second study of parenting skills at home and in laboratory observation of parent-child interactions, which was the only study to explicitly include fathers, also found no reliable change pre- to postintervention. The authors noted that aversive behavior scores for fathers in the treatment group did not differ significantly from scores of the nondistressed fathers in the no-treatment control group Reid et al.
Methodological factors, such as the use of observed effects versus self-report data and reliance on project-developed instruments rather than standardized assessment tools, discourage the comparison of these results with other studies. An evaluation was conducted of an intervention designed to change parental perceptions and expectations, to teach relaxation procedures to mediate stress and anger, and to train parents in problem-solving skills Whiteman et al. The results indicate that all three individual intervention strategies improved parents' scores on affection, discipline, and empathy indexes relative to no-treatment control parents.
A composite intervention, which combined all three strategies, produced the largest change in index scores. Findings from less rigorous studies, which did not meet the committee's selection criteria, examined the effect of teaching social skills to parents at risk of. Three studies report that parent support groups that offer social skills and problem-solving training are more successful with neglectful parents than programs offering more general content on child development Daro, ; Gaudin et al.
In a study of the Homebuilders program, the behavioral intervention to teach social skills was identified as an essential component Kinney et al. Parental mental health. New theoretical models that emphasize the interactions among social context, mental health, and family functioning have emerged in interventions for child maltreatment, focusing on the need to improve parental self-esteem, stress management, and the regulation of impulsive behaviors in order to enhance parental usually the mother's abilities to manage children through everyday care and discipline Wolfe, Since parental apathy and impulsivity are commonly associated with caregiver behaviors in cases of child neglect Polansky, , a number of studies hypothesize that improving parents' mental health will result in reduced child neglect.
The relevant outcome in this approach is the intervention's ability to produce beneficial changes in the parents' mental health relative to comparison groups, including reduction of depression and negative effects of life stress and enhanced self-esteem. Six studies report at least short-term improvements in scores on standardized measures for treatment parents in these areas Barth et al. However, the only study that included long-term follow-up reported that treatment gains were not maintained after a one-year interval, and the hypothesized connection between short-term competence enhancement and long-term prevention of maltreating behaviors lacked empirical support Resnick, Social support.
Social support has been described as the social relationships that provide or can potentially provide material and interpersonal resources that are of value to the recipient Thompson, The absence or presence of social support and involvement in social networks has been identified as an important risk factor for abusive families, especially in cases of neglect. Social support can provide a variety of services that help reduce stress in family life, including individual and family counseling, advice on parenting practices, child and respite care, financial and housing assistance, sharing of tasks and responsibilities, skill acquisition, and access to information and services.
A number of evaluations use social network assessment tools to determine if interventions can reduce social isolation for neglectful families, thereby decreasing propensity for neglectful behavior Barth et al. Two found no beneficial results in social support Barth et al. Schinke et al. A sixth study found initial improvement in social support that deteriorated over time Resnick, These results have not yet been able to suggest that network assessments will lead to more effective interventions or improved treatment outcomes DePanfilis, However, one less rigorous recent study suggests that collecting data on perceived social support, the reported frequency of use, and satisfaction with different types of support may provide better indicators of social support than structural features alone Tracy and Abell, Some research has focused on the role of ''natural helpers"—individuals who supplement the efforts of formal social service agents and who have connections to the values and norms of the community in the social environment of distressed families Collins and Pancoast, ; Thompson, , The efficacy of natural helpers in counteracting the multiple stresses of disadvantaged communities is not well understood; some research has suggested that creating a web of social support for families at risk of abuse or neglect may require connections with self-help groups such as Parents Anonymous or family support centers that are especially knowledgeable about the problems of child maltreatment and can provide counseling and advice outside the context of everyday social relationships Thompson, Home environments.
One evaluation looked at improvements in home environments as a proxy for decreased likelihood of child neglect with mixed results Larson, Larson found improvements in treatment group families. Social service interventions designed to improve parenting practices and provide family support have not yet demonstrated that they have the capacity to reduce or prevent abusive or neglectful behaviors significantly over time for the majority of families who have been reported for child maltreatment.
Although parental behavior can be modified in terms of stress, empathy, anger control, and child discipline, confidence in these and other proxy outcomes such as improved parental skills and altered perceptions of child behavior requires greater understanding of the key attributes of parental competence that relate to child maltreatment. Several interventions have demonstrated an ability to improve parental competence in the short term, but whether these gains can be maintained over long periods under stressful conditions and across different periods of the child's development is not certain.
The intensity of the parenting and social support services required may be greater than initially estimated in order to address the fundamental sources of conflict, stress, and violence that occur repeatedly over time in the family environment, especially in disadvantaged communities. Focusing as they do on single incidents and short periods of support, the interventions. The use of social networks to build and sustain parental competence is a separate area that requires further analysis.
The Ofsted interview: 'Children and families need consistency of social worker'
Although a parent's use of social networks to support family functioning can be influenced through interventions, there is not enough evidence to indicate whether changes in social networks can create changes in parenting practices that endure over time and result in reduced child maltreatment. The evidence, although intriguing, does not yet provide clear indications as to which types of families are most likely to benefit from parental education and family support services as opposed to mental health services designed to address depression, lack of empathy, and impulsive behavior in both parents and children.
Neither does the research base yet clarify whether enriching the supply of community resources will lead to expanded use of support services by families at risk of child maltreatment. Consistent dialogues between researchers and practitioners could facilitate greater awareness of the need to match families with individualized interventions. Sexual abuse prevention programs are organized around the theory that children can be taught to avoid abuse or to protect themselves from further abuse by reporting threatening or abusive situations and employing other learned self-protective behaviors Daro and McCurdy, Most child sexual abuse prevention education is classroom-based, brief in duration, and includes training on concepts of body ownership, types of touching, and skills to avoid or escape sexually abusive situations.
Children are encouraged "to tell. Some programs include a parental component, although such efforts are rarely evaluated Reppucci and Haugaard, Formats include skits, puppet shows, songs, films, videos, and story and coloring books. Table 4A-2 lists 14 evaluations in this area that meet the committee's criteria for inclusion. In general, these evaluations lack long-term follow-up data and rely on proxy outcomes, such as an increase in children's knowledge and skills Carroll et al.
The evaluations indicate that, although most programs can provide positive changes in cognitive skills and program-specific prevention behavior, especially when they draw on age-appropriate materials and special teacher training, the size and duration of this effect for children at different developmental stages remain generally unknown.
Two programs that included 1-to 6-month follow-up found that children retained "flight" responses to situational lures Harvey et al. However, the evaluations have not included long-term follow-up studies that could demonstrate that these changes constitute a sexual abuse prevention effect for the general population of children, reduce the risk of sexual abuse to the vulnerable children who receive. The studies demonstrate that children can retain prevention information, but retention may be influenced by age at exposure, length of training, and inclusion of review sessions. Moreover, there is some question about children's ability to translate knowledge into actual behavior and whether increased knowledge or learned self-protective behaviors do protect children from sexual abuse by family members.
The primary duty of state- or county-administered child protective services CPS agencies is to investigate and either substantiate or dismiss reports of child maltreatment; these casework management services as opposed to treatment and prevention services account for the large majority of the CPS budget in most communities. In the course of an investigation, social workers are charged with a dual responsibility: protecting the safety of the child and maintaining the family if that course is consistent with child protection.
Short-term interventions in this area include provision of casework services, concrete and therapeutic interventions, referral to community-based services, and short-term placements during the investigation phase. Services provided after investigation include concrete services, education, referral to community-based agencies, crisis intervention, treatment, and temporary or permanent placement in substitute care if necessary National Center on Child Abuse and Neglect, a.
There is wide variation in the duration, timing, and kinds of CPS interventions offered to maltreated children and their families, from no services to support, counseling, and placement services Meddin and Hansen, Some reviews of the effectiveness of social casework intervention with troubled families in general not just child protective services have indicated limited evidence of the effectiveness of casework intervention Lindsey, , noting that the caseworker often has little ability to change the structural and institutional barriers such as unemployment, dangerous neighborhoods, poor housing that confront many of their clients, limiting the scope of the intervention to smaller-scale problems.
There are no evaluations of child protective services that meet the committee's criteria for inclusion. Thus, several decades of experience with different types of CPS interventions remain relatively unexamined in the research literature, and the impacts of case identification and investigation procedures and practices are unknown. In the absence of a research base, policy makers rely on anecdotes and media accounts to formulate guidelines for casework interventions.
airtec.gr/images/rastrear-celular/2700-ver-conversaciones.php The available studies analyze how type of abuse and degree of risk influence rates of case investigation, substantiation, and child placement as a result of investigation Barth et al. At present, child sexual abuse is the most likely type of abuse to be investigated;. Once child maltreatment has been substantiated, assuming resources are available, caseworkers design a service plan. Many localities have adopted an array of services referred to as intensive family preservation services, which are designed to avert child placement in substitute care and, if possible, keep the family intact through the provision of therapeutic and concrete services, such as home appliance repairs and temporary rent subsidies.
Interventions in this area are short term and crisis oriented. Prior to referral for services, a child must be assessed as at imminent risk of removal from the family. Although specific components of these services vary, there are some common features Fraser et al. Generally, they are brief weeks , intense, home-based, therapeutic, and concrete; the caseloads tend to be small. In keeping with the Adoption Assistance and Child Welfare Act Public Law , the programs are shaped by the philosophy that, as long as their safety can be reasonably ensured, the best place for children to live is in their own homes.
Family preservation strategies are also guided by the theory that families are more responsive to change during periods of crisis and are more likely to engage in services at such times Heneghan et al. The outcome measures used in evaluations of intensive family preservation services are 1 prevention of child removal and 2 reduction in the length of stay in placement outside the home. Some studies count any type or length of placement in measuring outcome Feldman, , whereas other studies do not consider placement with a relative or other temporary placement Pecora et al.
The use of administrative data on placements excludes other indices of success, such as a reduction in the number of runaway episodes Bath and Haapala, And, although placement is a primary outcome measure, it is not always indicative of service failure Nelson ; Tracy, ; Wells and Biegel, Table 4A-4 lists 14 evaluations in this area that meet the committee's criteria for inclusion the use of a comparison or control group in the conduct of the study.
Some investigators found small or temporary effects on families Feldman, ; Schwartz et al. Others reported that the majority of families who receive services improved significantly and maintained improvements for 6 months to a year. Bergquist et al. Still others found no difference in the number of episodes of out-of-home placements for families who received services over comparison families, but they do report shorter placement episodes AuClaire and Schwartz, ; Schwartz et al.
In a methodological assessment of an identified field of 46 evaluation, 36 were excluded from further consideration because they used no comparison groups Heneghan et al. Four of the remaining group of 10 studies were also found to be methodologically unacceptable because of poorly defined assessment of risk, inadequate descriptions of the interventions provided, and nonblinded determination of the outcomes. The methodological review of 10 evaluation studies by Heneghan et al. The relative risk of placement was significantly reduced by services in only two studies; one of these sites had the highest rate of placement for both treatment and comparison groups.
Although intensive family preservation services may delay placement for many families in the short term Schwartz et al. The use of placement rates as a primary outcome is problematic, since it is a "program-based" measure that may not fully capture the range of positive effects of the intervention Heneghan et al. Attention to other child and family outcomes, such as child development, maternal-child interactions, episodes of maltreatment, and injury rates, might demonstrate more conclusively that these services provide better child and family outcomes than foster care, but these effects have not been tested in the evaluation literature.
At best, a day intervention can be expected only to stabilize the immediate crisis that places the child at imminent risk. Dramatic results cannot be expected in this area given the number and magnitude of the problems faced by many families and the variability in the services that are provided to them Schuerman et al. The results suggest that longer-term interventions may be required to sustain changes initiated by the intensive family preservation services and that the differential effects for different types of families need more attention.
Evaluations in this area are confounded by differences in the types of abuse and characteristics of families and children referred for services. Targeting services to families who are most likely to benefit from them is an important goal. However, it is uncertain whether improved targeting will significantly reduce. Several major issues require consideration in assessing the effectiveness of these interventions. First is the issue of targeting: Do the programs actually serve children at imminent risk of placement?
Many studies do not define what is meant by imminent risk and programs vary regarding the concept of "placement" Feldman, ; Tracy, ; Wheeler et al. As a result, it has been difficult to establish valid comparisons of results across studies. Furthermore, the decision about what constitutes imminent risk is usually based on the subjective judgment of the caseworker Rossi, ; Tracy, ; McCroskey and Meezan, Several studies question the utility of imminent risk as an eligibility criterion for the programs Ensign, ; Rossi, ; Schuerman et al.
They also do not account for the spontaneous remission of symptoms, as families reestablish their equilibrium after the abatement of the crisis that triggered the intervention Jones, ; Rossi, Until standardized definitions and objective assessment tools are adopted to measure services, placement, and risk, tests of the efficacy of an intervention strategy using this criterion will remain difficult.
In some cases, removal of the child from the home becomes unavoidable. Placement settings include foster care, therapeutic foster care, residential group care, and psychiatric hospitalization. Recently kinship care, or placement with a relative, has been included in this array of services. For teenagers who have remained in alternative care to adulthood, interventions have been designed to foster safety and self-sufficiency in the transition from foster care to independent living.
The number of children taken from their homes as a result of investigations is not clear Table One study of investigations indicated that A more recent study found that 56 percent of all indicated cases were closed the same day they were officially substantiated Salovitz and Keys, Estimates of the number of out-of-home placements as a result of maltreatment range from 1 to 15 percent for substantiated cases American Humane Association, ; Runyan et al.
Although out-of-home placements represent a small percentage of all services for children reported and substantiated for maltreatment, recent data from the U. General Accounting Office indicate a 55 percent increase in placement from to Adolescents ages 12 to 18 were the largest group in placement in ; by , children under age 5 are the largest group in placement Goerge et al. Rapid growth in the numbers of children who are placed outside the home is evident in urban centers associated with the onset of the drug epidemic, although the rate of placement relative to numbers of cases handled by the child welfare system has remained relatively stable.
The entry and length of stay fluctuates over time and between population subgroups, the number of infants entering foster care has increased dramatically, and infants have longer lengths of stay than children who enter at older ages Goerge et al. Table 4A-5 lists the four evaluations in this area that meet the committee's criteria for inclusion. Effectiveness of foster care has generally been measured in two ways: 1 whether or not the placement is permanent and 2 the level of the child's or adult's ability to function upon leaving foster care.
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Two studies reviewing long-term outcomes indicate that children who are removed from their. A study of infants in residential treatment showed short-term improvements in height and weight and interaction skills, a decline in psychomotor development pre- to postintervention, and a decline in interaction skills 5 months later Elmer, A fourth study reported that foster parent retention and satisfaction with their foster children's behavior can be enhanced by providing training, support, and increased stipends Chamberlain et al. Research on foster care outcomes generally consists of follow-up studies of youth in foster care with little comparison group analysis, weak retrospective designs, and small sample sizes, with significant attrition rates of subjects across studies Royse and Wiehe, A review of 27 less rigorous evaluations of foster care found a variety of poor outcomes including failure to complete high school, public assistance, homelessness, and frequent use of alcohol and drugs for adults who grew up in foster care McDonald et al.
However, there was significant variation in the methodology and results of the studies included in the review. Many of these studies compared foster care children to those who lived with their biological families without considering the issue of maltreatment. Longitudinal studies of children in foster care Fanshel and Shinn, ; Fanshel, ; Runyan and Gould, ; Widom, found generally favorable outcomes for children; the authors found no evidence that foster care alone was responsible for a significant portion of social adjustment problems, including crime and delinquency, encountered by child victims of maltreatment.
Other studies have found less positive long-term outcomes for adults who were children in foster care: their educational attainment is below average Palmer, ; Zimmerman, ; Festinger, ; Jones and Moses, ; their unemployment is higher than in the general population Festinger, ; Barth, ; Jones and Moses, ; Zimmerman, ; and housing for many is marginal or unstable Russell, ; Harari, ; Jones and Moses, ; Susser et al.
Since those studies were completed, the Independent Living program has been initiated in many states, specifically targeting youth ages 16 to 18 leaving foster care. The purpose of this program is to help prepare foster children for the transition to independence, including specific training in employment, education, and other basic living skills. Studies conducted on youth leaving foster care in the s may reveal different results.
A key question for foster care research studies is whether out-of-home placement for children who have experienced abuse or neglect creates a separate. The evaluation research base is not sufficient to provide clear answers, but longitudinal studies suggest many children who reside in foster care fare neither better nor worse than those who remain in homes in which maltreatment has occurred. However, the changing character of children in foster care over the last decade, with the trend toward increased placement of children under age 5, requires new studies to examine whether the age, length, or stability of placement is correlated with beneficial or adverse outcomes, especially when children in placement are compared with young children who have been maltreated but remain with their families.
Prior research has shown that the younger the child is at placement, the less likely the child will return home. Comparing family foster care to residential services a group home or center-based form of placement suggests that children in foster care are better able to function in less restrictive post-discharge environments and are more often discharged to family or relative care. Foster care appears to offer significant cost advantages compared with residential treatment Hawkins et al.
But there is some question as to whether children in foster care and residential treatment are comparable in terms of their mental health and experience with trauma Barth et al. Interpretation of the data on whether placement in foster care is permanent is made difficult by the need to average across all children in placement Shyne and Shroeder, ; Wiltse, Although residential services are widely used as an intervention for older and more disturbed youth who cannot live with their families, they have not been assessed to determine their effectiveness.
There is little empirical evidence available to identify which characteristics of an after-care intervention are effective, although such services are widely acknowledged as important Whittaker and Pfieffer, ; Jenson et al. Out-of-home placements may not necessarily signal the end of service provision to the child victim; in some cases, intensive programs are designed to prevent the need for other, more costly, or perhaps stigmatizing interventions.
Individualized service programs have been developed to identify flexible and intensive intervention plans that meet children's needs and provide services in the least restrictive environment, either with their biological families or not. These programs emphasize consideration of the total environment in which the maladjusted behavior occurs rather than focusing solely on the child's behavior. The majority of the research in this area is descriptive or focuses on implementation issues Burchard et al. Most evaluations are anecdotal, drawing on nonstandardized measures and data-gathering procedures.
Table 4A-6 lists the three evaluations in this area that meet the committee's criteria for inclusion. Two studies that measured the comparative success of individualized service interventions against subsequent reports of child maltreatment and removal of the child did not show positive results Hotaling et al. Both found that children receiving individualized services were just as likely to live out of the home and their families were just as likely to be the subject of maltreatment reports as comparison families receiving routine community services.
One of the most rigorous studies of individualized service interventions compared children in foster care who received individualized services to children who did not Clark et al. Both groups had significantly improved scores on measures of emotional and behavioral adjustment, but children who received individualized services had significantly improved scores on certain dimensions such as withdrawal of attention.
The treatment group had significantly fewer days of incarceration and fewer felony convictions than the comparison group. The very nature of individualized service interventions makes them difficult to evaluate, and the evaluations difficult to compare. Because each family in the treatment group is theoretically receiving the mix of services designed to address its particular needs, repeated iterations would be required to identify the "best" or "most effective" mix of services for a particular kind of family. Trying to generalize from one study population to another with different characteristics and problems would require increasingly complex methodology.
The most effective approach may be to design methodologically sound evaluations of each individual service plan, and then design evaluations to test varying service packages. Today, there are approximately 1, programs in the United States for victims of violence by spouses and intimate partners; approximately 1, of these programs are shelters Plichta, Shelter programs emerged in the s in response to grass roots concerns about the need to provide places of safety and emotional support for battered women and their children.
The shelter movement has evolved to include a broad array of related social services, including hour hotlines, counseling, job training, medical and legal assistance, referrals to drug and alcohol treatment, and housing assistance. This combination of crisis intervention and social support has emerged in a variety of settings, including religious organizations, women's organizations, hospitals, and community development programs.
Individual social workers, psychologists, and clinics also provide services to victims of domestic violence. Mental health programs for battered women and children who witness domestic violence are discussed in the chapter on health interventions. Programs for male perpetrators of domestic violence are discussed in the chapter on legal interventions, since the client referrals to these programs are largely administered through the courts. As in the field of child abuse, variation in the outcomes identified complicates the task of designing and implementing evaluations of services for battered women.
Although the ultimate goal is to foster violence-free lives, it is often unrealistic to expect a brief intervention focused on the victim to create a situation in which a batterer is no longer violent. Interim outcomes are therefore often used to judge the effectiveness of interventions—such as greater empowerment and increased options for victims, improved life skills including improved communication and self-assertive skills , and more effective use of available community services.
Even these proxies, however, are difficult to quantify in a standardized way Table Given the difficulty of precisely defining desired outcomes of interventions for domestic violence and the even greater difficulty of quantifying them, only a small number of quasi-experimental evaluations of such interventions exist. Some evaluations that did not meet the committee's criteria for inclusion nonetheless are discussed below because they are valuable in their attempt to clarify issues in outcome measurement and program implementation.
Discrete actions accomplished e. Four interventions are described in the sections that follow: 1 shelters for battered women, 2 peer support groups for battered women, 3 advocacy services for battered women, and 4 domestic violence prevention programs. No national data exist on the number or the characteristics of clients who are served by various shelter programs.
Individual state data on waiting lists and turn-away rates indicate that the resources are inadequate to meet the needs of victims of domestic violence National Research Council, Women who go to shelters tend to be from lower socioeconomic groups. Women with more economic resources may not appear in shelter samples because they are able to pay for temporary shelter or rely on housing provided by friends or relatives; they may seek other services through private means.
The racial makeup of shelter users seems to reflect the regional location of the shelters. It may be that women who use shelter services are experiencing the most serious violence at home and therefore do not represent other women who are victimized Berk et al.
Depending on the degrees offered, schools might be accredited by a regional accrediting board or other body approved by the U. Department of Education. Social work programs can obtain accreditation from specialized organizations like the Council on Social Work Education. Some states require social workers to be licensed or certified. Since regulations vary from one state to another, get information about your state's requirements from the Association of Social Work Boards. Working as a clinical social worker may require a license where you live.
As with an internship, depending on the community and availability, your first job in the field may not be the exact position or concentration you intend to pursue. In the beginning, it is important to gain as much relevant experience as possible. Classroom instruction is important, but time spent in the community can be even more transformative. As you grow comfortable with your skills and your role, you can continue seeking your ideal career. Returning to college to add a post-graduate degree is one way to advance in the social work field. Many public service organizations require employees to take part in continuing education.
Advancement and rank promotions can be pegged to years of service, work performance and formal advanced training. In some cases, you may want to change fields. For example, with additional post-graduate work, you might move from performing family assistance casework to a position as counselor, staff director, facility manager or administrator. If a student is considering a career in social work, there are many different routes he or she can take, each of which presents its own set of opportunities.
Educational commitments might last anywhere from two to ten years, depending on how much education and training the student wishes to pursue. If a student has decided on a career in social work, the next step is figuring out which course of study to take and how far he or she wants to go in academia. A student can enter several different types of degree programs, which teach basic to advanced skills and tools used in social work.
An associate degree in social work provides the fundamentals for careers in the field. Students learn about the history and development of social work over the centuries as well as the code of ethics required. Courses introduce the basics of psychology, human development, anthropology, sociology, and mental health and also explore critical issues in contemporary society, such as poverty, discrimination, obesity, and other poor health conditions.
Having an associate degree in social work can lead to entry-level careers such as a social services assistant or case manager assistant. General overview of social work for those interested in this field or related careers. Examination of fundamental aspects of social work includes professional values, information and skills in both historical and contemporary contexts.
Exploration of how humans develop physically, cognitively, culturally, and socially over their lives. Analysis of how these processes of development work together to create a unique personality. Broad overview of major psychology disciplines and topics. Students learn the foundations of psychological theories, particularly as they apply to a future in social work. Basic survey of many conflicts and problems that exist in modern society. Students learn to formulate hypotheses when observing and analyzing social issues. Students learn not just the theory behind social work but actual practices to put into play to interact with and help clients and communities as a whole.
A baccalaureate also means tackling the complete liberal arts background required, along with more specialized courses. A social work degree at this level can help graduates achieve more advanced positions than they could with an associate degree. This course teaches the foundations for conducting research and analyzing statistics and outcomes.
Students learn how to perform their own studies and draw conclusions by determining the relationship of statistics and research methods. Curriculum tackles different aspects of the law, both civil and criminal, and how these affect and apply to children. Topics include juvenile court system, wardship and dependency, and legal ramifications of divorce and custody changes. An introduction to this complex and intricate arena gives students the tools to navigate health systems while coordinating and providing care for others.
Emphasis is typically on certain groups such as economically disadvantaged communities. This includes studying specific types of addiction and ways to intervene and prevent further problems. In this program, students learn more advanced theory and practical guidelines to enable them to work more autonomously, for example, through their own practice. Coursework focuses on building strong professional foundations and enhancing existing knowledge and skills needed to handle populations with various vulnerable life conditions.
Field instruction is also a crucial component. This allows students to work part-time for a social service agency in their chosen concentration, gaining valuable hands-on training and direct exposure to daily work.
This course focuses on the welfare of a wide range of populations, both currently and historically. Students learn about different services and agencies available and policies in place to provide assistance for populations in need. This course takes an in-depth look at human behavior and how and why social behaviors have evolved. Students analyze the evolution and interaction of individuals, families, organizations and communities as well as theories of personality, health, behavioral disorders, family dynamics and organizational behavior.
This course offers a more thorough and analytical approach to address social and cultural diversity, both theoretically and in practice. In learning to work with oppressed and vulnerable populations, students discover how to empower them to help themselves. This course provides a broad spectrum of knowledge and skills related to social work in healthcare.
Students examine healthcare delivery systems from historical, social and economic perspectives, particularly as they affect specific populations, such as women, children and people with mental illness. A doctoral degree in social work does not lead to a higher level of licensing, but it can open other doors for advancement. This is particularly true for careers in research, social work education, or higher-level administrative positions. The DSW is generally seen as emphasizing practice, while the PhD is commonly thought of as research-focused.
Both social work doctorates offers the highest educational recognition in the field, in addition to a toolbox full of skills specially honed by a doctoral candidate's dedication to further exploring and advancing the field. Examples of the high-level skills doctoral students develop are discussed below. Those with doctoral education become a resource for colleagues and can earn increased trust from community leaders.
This degree can prepare educators or policy analysts or lead to highly inventive research, including emerging and cutting-edge intervention strategies and how to apply them in practice or a community setting. With a doctorate in social work, graduates can lead research teams at universities and for various organizations, including the government. Also emphasized in doctoral programs are managerial techniques needed by administrators of public and private social service organizations. Social work research is complex, and those who have earned a doctorate have probably come up with ways to conduct extensive and innovative research projects.
These programs offer experience in testing populations and drawing insightful conclusions to provide answers to questions that others may have missed. A PhD candidate has likely not only learned about the policies and program administration related to social work--he or she has also navigated those channels many times. Once a student decides on an academic path, the next step is to choose a particular concentration.
The specialties within social work are numerous and varied. Below is a breakdown of some of the most common options. Social workers are the most common clinically trained mental health professionals in the United States. Their work is more necessary than ever: About one in five adults in the nation is identified as having a mental illness, according to the Substance Abuse and Mental Health Services Administration.
This concentration focuses on psychosocial assessments of common mental issues and illnesses and developing and implementing treatment plans to help individuals and families. It also delves into mental health policies and healthcare delivery systems. Clinical positions generally require post-graduate supervised experience and a license. Sees patients in a clinical setting, usually in private practice or in a shared practice with other social workers, psychiatrists or mental health professionals. This generally entails long-term care over time with regular--sometimes emergency--appointments.
Sees patients in a hospital setting, which may mean providing more acute care on an on-call basis. For example, someone may arrive in the emergency room after a failed suicide attempt or threaten to commit harm to themselves or others.
Sees pediatric patients, usually in a clinic or school setting. Handles child-specific illnesses, behaviors, and temperaments that can arise in either normal or stressful situations for the child. While this concentration can overlap with mental health, it may present an entirely different set of mental, physical and emotional instabilities that a social worker can guide the addict through. This package of resources provides a summary of research evidence on reflective supervision alongside learning from practice, and tools to use in one to one and group supervision sessions.
These resources are the outputs of a Research in Practice Change Project. Aimed at: Staff with supervisory responsibilities across early help, targeted support and statutory services with children and families. Published: Mar Contact after adoption: Learning Resources open access. The type and frequency of contact a child has with their birth family needs careful consideration and planning, and should be determined by the needs and best interests of the child, both in the long and short term.
This open access website provides resources for practitioners in making evidence-informed post-adoption contact plans and supporting birth relatives and adopters through contact and planning for their child. The resources cover:. Aimed at : Those involved in making, reviewing and supporting plans for post-adoption contact. These learning resources are open access. Go to the contact after adoption website. Published: Feb Child sexual exploitation: Practice Tool open access.
This is an open access resource. The document outlines the new civil definition of child sexual exploitation, developed by the Home Office and DfE, together with an overview of our current understanding of the issue and an evidence-informed set of principles for responding. Number of pages: 75 This PDF download is an open access resource. Published: Aug Positive mental health and wellbeing in children and young people: Suggestion for practice This resource aims to help those working with children and young people to: Develop the skills needed to identify mental health needs.
Recognise areas of strength and resilience in young People and parents. Provide support through direct work with families. Published: Aug Responding to self-harm among children and adolescents: Suggestions for practice This resource complements the Understanding self-harm among children and adolescents: Frontline Briefing and is designed to support practitioners in their everyday practice to use research evidence in relation to self-harm. The four core sections address: What is meant by self-harm, as well as signs of, and risk factors associated with, self-harm.
Reasons why young people self-harm and links between suicide and self-harm. How to respond to disclosures of self-harm and engage with young people, including assessments.