SpringerBriefs in Well-Being and Quality of Life Research For further volumes: http://www.springer.com/series/10150 Elizabeth Fernandez Accomplishing Permanency: Reunification Pathways and Outcomes for Foster Children 13 Elizabeth Fernandez University of New South Wales Sydney NSW Australia ISSN 2211-7644 ISBN 978-94-007-5091-3 DOI 10.1007/978-94-007-5092-0 ISSN 2211-7652 (electronic) ISBN 978-94-007-5092-0 (eBook) Springer Dordrecht Heidelberg New York London Library of Congress Control Number: 2012942713 © The Author(s) 2013 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer Permissions for use may be obtained through RightsLink at the Copyright Clearance Center Violations are liable to prosecution under the respective Copyright Law The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made The publisher makes no warranty, express or implied, with respect to the material contained herein Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Dedicated to Sienna, Antonia, and Quinn Foreword This book tells a multi-faceted engaging story about foster care and permanency in Australia—a story that has international value Although every country’s foster care program has a somewhat different set of assumptions and history, foster care was established, principally, to be a temporary refuge for children and support for families Yet, for 50 years research has been clear that reunification has been an extremely challenging and, often, overlooked component of child welfare services Children’s services programs recognize—at least by assertion if not by program design or funding—that almost all parents should have reasonable services to allow them to resume the care of children removed from them and that children also deserve the chance to go home to homes to which they typically want to return Fernandez makes a strong argument that reunification is understudied and has provided an exhaustive review of international studies of reunification going back more than three decades The review explores the impact on the likelihood of reunification that arises from prior child welfare involvement; multiple placements; children’s behavior problems; birth family characteristics; and race, ethnicity, and tribal standing She highlights the consistent findings but also identifies some anomalies Although the study does not, alone, untangle all of these issues the prospective and multi-method design certainly adds new information about many of these topics By combining elegant analyses of the administrative data (using both event history analysis and person-centered latent profile modeling) with countless excerpts from caseworkers, foster carers, and parents, Fernandez brings an extra dimension to this study Indeed, the inclusion of parent perspectives on achieving reunification—with attention to their views of child welfare workers—provides a very vivid picture that has immediate implications for supervision and training The material on the amount of contact between the foster carers and the birth parents was quite useful to me, as an American student of child welfare, where this still remains somewhat infrequent; nearly two-thirds of carers reported meeting with the birth mother more than weekly They also reported greater interest in having those visits occur in their own home Contact with fathers and siblings was also frequent Like so many carers, those in this interview sample had an abundance of ideas about how they could be more effectively included in case vii viii Foreword planning The chapter on perspectives of carers also includes information about the carer’s views of reunification, training, and their relationship to the caseworker; this is one of the longest and most valuable chapters in this excellent volume Fernandez provides a very useful summary of the implications of this landmark study in the concluding chapter on reunification policy and practice The findings integrate the new work in this volume with suggestions offered by colleagues in other countries Some are new and all of them amplify the call for re-emphasizing reunification, developing better practice models (which is much more possible with the information provided here), and designing services to be more in keeping with the developmental ages of children Fernandez has done what so many of us wish we have been able to but often could not—she followed a cohort of children and found many ways to tell their story (whether it ended in reunification or not) with considerable richness So often we are limited to less time and fewer perspectives This study is not only informative, in its own right, but is also an exemplary model for future scholars Like the lives of so many child welfare involved families this book also tells stories of adversity and triumph for families and of the forces of healing that we know exist within child welfare systems in every country but continue to need to be coaxed forward with stringent analyses and creative responses Baltimore, USA, April 2012 Richard P Barth Dean and Professor School of Social Work University of Maryland Acknowledgments The research described in this book was a team effort involving senior staff of the collaborating agency, caseworkers, carers and families, and university-based researchers I would like to thank the Board of Barnardos Australia for their collaboration and support in this research endeavour In particular I would like to acknowledge Louise Voigt, Chief Executive Officer of Barnardos Australia for her leadership and commitment to research informed practice I extend my thanks to Rosemary Hamill for co-ordinating the research across the agency, and Kerry Moore, Jan Williams, Agatha Pumpuhar, Carol Lockley and Annette KellyEgerton, Senior Managers for facilitating data collection at specific research sites Special thanks are due to the team of caseworkers of the Temporary Care Program who permitted their work to be scrutinized by researchers and responded with great generosity to the data collection process Thanks are also due to the foster carers and birth parents who gave generously of their time and shared their valuable lived experience to assist in the process of knowledge building in this vital area of child welfare practice Thanks are due to researchers Jessica Rojas, Rosemary Richards, John Healy and Amy Godleman for their specific contributions at various stages of the research to data collection, data analysis, and data presentation I would like to thank Dr Jung-Sook Lee for her contribution to the statistical analysis in Chap The particular contributions of Jessica Rojas, Sarah Meoli, and Cassy Spratt in transcribing taped interviews and data entry are also acknowledged I am grateful for the dedication of several student assistants who were associated with data collection as part of their social work research internships on the project I would like to thank Paul-Auguste Cornefert for meticulous care in formatting and professional presentation of this monograph I thank Robert Urquhart for expert professional editing of the text My debt to Carl, my husband, is immense for his patience understanding and inspiration through the extended process of completing this book The research was made possible by an Australia Research Council Grant and funding from the Telstra Foundation This support is gratefully acknowledged ix Contents Accomplishing Permanency: Reunification Pathways and Outcomes for Foster Children 1.1 Introduction 1.2 The Context of Child Protection and Out of Home Care 1.3 Background 1.4 International Research 1.5 Methodology 1.5.1 Research Aims 1.5.2 Research Design 1.5.3 Site of the Study and Participants 1.5.4 Data Collection 10 1.5.5 Data Analysis 11 References 12 Family Characteristics and Histories 15 2.1 Child and Family Attributes and the Likelihood of Reunion 15 2.2 Family Profiles 16 2.3 Family Structure 17 2.4 Financial Pressures 20 2.5 Family Support Networks 21 2.6 Family Violence 24 2.7 History of Past Abuse 24 2.8 Domestic Violence 25 2.9 Physical and Mental Health Concerns 27 2.10 Substance Abuse 28 2.11 Physical Environment 28 2.12 Conclusion 29 References 29 xi xii Contents Reasons for Children Entering Care 31 3.1 Difficulties Experienced by Families that Precipitated Placement 31 3.2 Children Placed for Reasons of Abuse and Neglect 33 3.2.1 Physical Abuse 33 3.2.2 Emotional Abuse 35 3.2.3 Sexual Abuse 36 3.2.4 Neglect 37 3.3 Parental Capacity as a Reason for Placement 39 3.3.1 Mental Health 39 3.3.2 Substance Abuse 40 3.3.3 Parents Ability to Cope 41 3.3.4 Lack of Social Support 42 3.3.5 Children’s Challenging Behaviour 42 3.4 Environmental Issues and Inadequate Accommodation 43 3.5 Conclusion 44 References 44 Assessment and Intervention 45 4.1 The Need for Standardized Risk and Need Assessment Instruments in Intake and Intervention in Protective Care 45 4.2 Assessment of Need at Intake to Temporary Family Care 48 4.2.1 Overall Environment: Time 48 4.2.2 Overall Parental Capabilities: Time 49 4.2.3 Overall Family Interactions: Time 49 4.2.4 Overall Family Safety: Time 51 4.2.5 Overall Child Wellbeing: Time 51 4.2.6 Overall Caregiver/Child Ambivalence: Time 53 4.2.7 Overall Readiness for Reunification: Time 53 4.3 Assessment of Need and Change Post-Intervention 54 4.3.1 Overall Environment: Time 54 4.3.2 Overall Parental Capabilities: Time 54 4.3.3 Family Interactions: Time 56 4.3.4 Family Safety: Time 56 4.3.5 Overall Child Wellbeing: Time 57 4.3.6 Overall Caregiver/Child Ambivalence: Time 58 4.3.7 Overall Readiness for Reunification: Time 59 4.4 Problem to Strength Shifts by Overall Domain 60 4.4.1 Overall Environment 60 4.4.2 Overall Parental Capabilities 61 4.4.3 Overall Family Interactions 61 4.4.4 Overall Family Safety 63 4.4.5 Overall Child Wellbeing 63 140 10 Informing Policy and Practice in Reunification Substance abuse was found to be present among many parents, and often coexisted among issues of domestic violence and neglect Substance addiction hindered parents from parenting adequately Many parents lacked adequate parenting skills, firstly due to a lack of positive parental role models when they were young and secondly due to the impairments caused by substance addiction, illustrating the theme of intergenerational neglect and/or abuse which emerged in the interviews with case workers and parents Parents who were in care themselves and/or experienced extreme abuse faced difficulties in parenting adequately Some parents placed their child in care voluntarily because they recognised their inability to cope and sought help Children’s challenging behaviours also contributed to entry into care In 26 % of cases, children’s challenging behaviour was cited by carers as reason for entering care However, the interactional effects of child abuse and neglect, for example the debilitating context of prolonged exposure to home situations with high levels of marital and parent–child discord, coupled with poor child-parent attachment, in precipitating aggressive and anxious behaviours need to be taken into account in designing interventions to assist children with difficult behaviours The physical environment was often seen by caseworkers as particularly problematic This included unstable accommodation, unhygienic living quarters and limited space and resources for the children living at home The issue of inadequate accommodation must be revisited here A majority of families lived in DOH dwellings These families were surrounded by other families with similar problems, suffered inadequate social support and at times lived in buildings where there were other drug dealers and users, creating temptations for parents trying to abstain from drug use A lack of social support was prevalent amongst families A lack of both formal and informal support often exacerbated parenting difficulties This absence related to both a lack of ability to form social networks, a lack of connection to extended family and having access to support that was unreliable The data on reasons nominated by agency caseworkers as to why children entered protective care reported in Chap. 4, was complemented by the use of a standardised measure of family need and family functioning collected over time The North Carolina Family Assessment Scale-Reunification (NCFAS-R) which was originally designed for family assessment and outcome measurement in family preservation services and child welfare programs was used (Reed-Ashcraft et al 2001) Family functioning, measured according to the NCFAS-R prior to intervention and post intervention illustrates the relatively high level of need and/or risk of harm prior to entering TFC (Chap. 4) The instrument was completed either at intake or within 6–8 weeks of intake (Time 1) and—depending on which came first—at the closure of the case, or 6 months after the initial interview, or at the time of the reunification (Time 2) The domains by which families were measured against the NCFAS-R were: overall environment, overall parental capabilities, overall family interactions, overall family safety, overall child wellbeing, overall caregiver/child ambivalence and overall readiness for reunification Substantial difficulties were experienced by families across a number of these domains: in terms of overall environment, over three-quarters (77.0 %) of families were experiencing mild to serious problems, which included problems with the learning environment, 10.2 Pre-Intervention Characteristics 141 financial management, and food and nutrition Tellingly only an eighth of families (12.5 %) of families’ overall environments were considered a strength In terms of overall parental capabilities, most (86.8 %) were seen to be experiencing problems, more importantly with the majority of family problems (70.2 %) being of a moderate or serious (rather than mild) nature, and the subscale of supervision of children reflecting the greatest concern, where two-thirds (66.7 %) of families were experiencing moderate to serious problems pre-intervention In nearly half (47.7 %) of these cases substance abuse was considered a serious problem affecting parenting In terms of overall family interactions, nearly three-quarters (74.1 %) of families were experiencing problems, with 12.7 % being of a serious nature Concerns with family safety and the absence of pre-existing strengths that can be built on characterised most families in the sample The domain of family safety shows that most (86.1 %) of families were experiencing problems, including neglect in 65.1 % of families, emotional abuse, a moderate to serious problem in 48.4 % of families, and domestic violence a moderate to serious problem in 42.0 % of these cases Only a small minority of families (7.3 %) were considered to possess clear or mild strengths in regard to overall family safety For the category of ‘overall child wellbeing’, problems were seen in 60.8 % of cases, with only 30.4 % being moderate to serious Interestingly, on several subscales for the domain of children’s wellbeing showed that despite overall concerns with environment, parental capabilities, family interactions and safety, families still displayed strengths rather than problems, evidencing an important capacity for resilience in the children Only a small sub-group (13.0 %) of families displayed any moderate to serious problems in co-operation and motivation to maintain the family and most families (82.0 %) were rated as being either on the baseline or having clear to mild strengths Strikingly, given the multiple stressors observed on parent–child relationships, 57.0 % of families were rated as being at baseline or above pre-intervention on the relationship with parent(s)/caregivers subscale For overall caregiver/child ambivalence, only 17.5 % were having moderate to serious problems However the subscales for this domain varied by the direction of ambivalence—whereas only 15.7 % of families experienced moderate to serious problems with child ambivalence to the parent/caregiver, double the rate (32.4 %) were considered to have moderate to serious problems with parent/caregiver ambivalence expressed towards the child The latter level is important as the study interview data showed that caseworkers viewed perceived parental empathy and engagement with the child as a key factor in predicting the likely success of reunification (and hence in assessing the suitability of reunification) This view of frontline workers is consistent with previous research by Hess et al (1992) that a significant impediment to implementing successful reunification is parental ambivalence The overall readiness for re-unification domain showed that 72.5 % of families were experiencing problems This was consistently reflected in the carers’ accounts (Chap. 9) Carers perceived a high level of birth family difficulties that inhibit a child successfully returning, with 74.0 % describing parenting difficulties, 63.0 % drug and alcohol and 39.0 % domestic violence 142 10 Informing Policy and Practice in Reunification In terms of case goals specified by caseworkers in Chap. 5, addressing drug and alcohol issues was the most common goal for families, followed by establishing support to improve families’ coping strategies, followed by the third most common goal which was long term care or adoption 10.3 Post-Intervention Characteristics All cases entering the TFC program over the four years of the study (168 children from 96 families) were included in the total sample During this period, just over half (53.0 %) of children were restored to their birth parents or kin, with 47.0 % not being restored While there are only a limited number of longitudinal studies which follow children from the point of entry into care to returning home or remaining in long term care, Biehal notes that the four main available UK studies reported varying rates in the proportion of children who came into care and returned home ranging from 27.0 to 58.0 % after 6 months had elapsed (Biehal 2006) In terms of the seven family functioning domains of NCFAS-R at Time 2, substantial changes in the level of need and/or risk of harm were witnessed across a number of these domains Familial difficulties in overall environment decreased from 77.0 to 57.0 %, as well as showing reductions in level of severity from 16.5 % which were considered to be serious problems in nature to 6.6 % postintervention Moderate to serious problems in the domain of parental capabilities decreased from 70.2 to 39.1 % Families significantly strengthened their parenting capacity, with 39.7 %—or triple the 13.3 % considered baseline or above (clear to mild strength) at Time However, half of these families assessed as having moderate to serious problems still experienced problems with alcohol and/or drugs Overall family interactions improved, from 74.1 % experiencing mild, moderate and serious problems to 51.1 % While some aspects of overall family safety improved with only 48.0 % showing problems, compared to 86.1 % before entering the TFC program Domestic violence was still a moderate to serious problem in 24.1 % cases, while neglect remained a serious problem in 33.6 % of cases Moderate to serious problems in child wellbeing decreased substantially from 30.4 to 6.9 % Overall caregiver/child ambivalence was problematic in 28.2 % of families (compared to 61.1 % pre-intervention) Notably parental/caregiver ambivalence towards the child decreased from 32.4 % rated moderate to serious problems to 17.7 % Child ambivalence towards the parent/caregiver, already low compared to parental ambivalence, decreased only slightly from 15.7 to 12.3 % Problems in overall readiness for reunification reduced from 72.5 to 48.9 % Summarising the observed trends at the level of the overall domains (collapsing the original six-point ordinal scale to a four-point ordinal scale): • Overall environment most notably improved in the moderate to serious problem rating—from close to half of families (48.7 %) decreasing to 29.8 % at Time 10.3 Post-Intervention Characteristics 143 • Overall parental capabilities rated in the moderate to serious problem category decrease from 70.2 % of families to 39.1 % at Time 2, an encouraging improvement (albeit indicating nearly 39.1 % of families were still experiencing moderate to serious problems at closure) • Overall perceived strengths in family interactions increased positively—families rated as having clear and mild strength increased from 19.3 to 26.8 %; whereas an even greater increase was observed in families rated as baseline from 6.7 to 22.2 % • Overall family safety showed considerable improvement most notably in those considered having “clear to mild strengths” which almost quadrupled in size from 7.3 % of families pre-intervention to 26.7 % at post-intervention Those experiencing moderate or serious problems decreased from more than half (55.6 %) of cases to a third (33.3 %) by closure • The child well being domain reflected significant improvements, moderate to serious problems declining from 19.9 to 6.9 % In addition the number of families displaying strengths increased by 32.5 % • Overall caregiver/child ambivalence findings were mixed depending on the level of severity of the problem—the number of families displaying strengths increased considerably from 16.8 % at Time to 42.9 % at Time Whilst 43.6 % families displayed mild problems before entering TFC, this had decreased to 15.4 % of families by closure, whereas those considered to have moderate to serious problems showed less improvement, decreasing from 17.5 to 12.8 % of all families • Overall readiness for reunification showed improvements in families presenting strengths increasing from 16.7 % pre-intervention to 38.8 % post-intervention, whereas those families experiencing moderate to serious problems showed a smaller change (a decrease in the proportion of families affected from 51.0 to 39.4 %) Taking the latter group together with the 9.5 % of families still experiencing mild problems post-intervention, nearly half the sample (49.0 %) still displayed problems that in their caseworkers’ estimation impaired their readiness for reunification This is consistent with the rate of reunification (53.0 %) observed in the study The number of cases not restored (47.0 %) most likely reflects the persistence of problems reported in this domain—i.e half of families were still experiencing problems with regard to their preparedness to reunify despite the intervention The reverse also holds true—where families had achieved either the baseline functioning or at the level of a strength, in nearly all cases they were reunified Whilst capturing fidelity measures were outside the scope of this study, this is perhaps indicative of a good fidelity in implementation in relation to the caseworkers’ practices Consistent with the program’s philosophy, this evidences that—once caseworkers have reached a clinical judgement that family functioning has been sufficiently enhanced and pre-existing problems and support needs have been addressed—they have been vigorously following through on plans to enable children to return home, and are thus ensuring children are not kept in care placements any longer than family circumstances necessitate 144 10 Informing Policy and Practice in Reunification The qualitative findings showed that caseworkers perceived that overall p arenting capacity was quite low, and worked to increase the strengths in this domain Multiple services were also drawn upon to assist parents with multiple and intersecting issues that affected their parenting Practical assistance and establishing a range of informal and formal social supports, were seen by caseworkers as the most useful assistance they could provide to enhance the chances of reunification Many parents affirmed the positive impact carers had on their children, particularly in terms of developmental advancements of infants and their children’s behaviour Some parents discussed the positive parenting skills that carers had modelled for them 10.4 Charting the Pathways as Experienced by Children in Care Caseworkers frequently reported their frustration with setting up and maintaining care arrangements that they judged would meet children’s individual needs, as this process was often hampered by the limited availability of carers, particularly experienced carers who could manage extreme behaviours, and Indigenous carers Caseworkers often attempted to place sibling groups together, unless siblings needed one on one care or they were displaying extreme behaviours towards each other Caseworkers often sought carers who displayed a number of personal attributes, including ‘warm’, ‘caring, ‘non-judgemental’ and ‘down to earth’ qualities Carers discussed the ways in which they cared for the children, including providing for their basic needs, in addition to meeting psychological, emotional and affectional needs They discussed the positive changes they often witnessed, particularly in terms of developmental growth with babies and infants Of the restored group of children, nearly a fifth (19.0 %) of children spent less than 4 weeks in TFC before being restored to their birth families, 23.0 % were in care for 1–2 months, 21.0 % were in care for 3–6 months, 24.0 % were in care for 7–12 months and 4.0 % were in care for over 12 months This corresponds to reunification patterns highlighted in the introduction, whereby the probability of reunification drops dramatically after one year in care (Wulczyn 2004) A large percentage of children had experienced previous placements, with more than half (60.0 %) of children experiencing at least one placement other than the current placement Nearly half (47.0 %) of these children had already had 1–2 other placements, with a small but significantly vulnerable cohort (5.0 %) of children experiencing a higher level of placement instability A fuller discussion of placement trends in the TFC program is available in Tregeagle and Hamill (2011) Unfortunately, challenging behaviour (often a manifestation of extreme abuse or an inability to cope with separation from parents) led to placement breakdown in some situations, which in turn led to children feeling insecure, rejected and angry and more prone to act out these feelings in future placement settings Given the reported incidence of challenging behaviours and its subsequent role in placement 10.4 Charting the Pathways as Experienced by Children in Care 145 breakdown, the importance of carer training and its relationship to placement stability perhaps cannot be overestimated In a recent study of the role and responsibilities of carers of young people with high support needs (sometimes referred to as ‘high-intensity fostering’), participant carers identified a number of elements they felt were crucial to skilful caring and which helped them play their part in avoiding breakdown of a placement These included (1) developing strong relationships with caseworkers and being able to call on them for assistance and guidance as needed, (2) having access to on-going training, (3) recognising one’s strengths and limitations as a carer and being comfortable with that knowledge, (4) establishing contact and discussing practical issues with other carers (usually within the formal training context), and (5) developing the ability to think through problems which arose in the placement and to respond with appropriate and effective strategies That participants felt them to be key factors which helped them carry out their caregiving indicates the important role training can have in contributing to placement stability and the retention of carers (Doyle 2010) In the context of the present study, the agency as a routine practice provides systematic and on-going training for carers, which was valued immensely by carers With the increasing numbers of children entering care who have both a history of being maltreated and biological parents with complex and entrenched problems there may well be a need for specialised carer training on the particular demands and challenges of reunification practice, and for the carers of the cohort of children display challenging behaviours, specialised training in children with high-level needs to help mitigate placement breakdown 10.5 Child and Family Characteristics Associated with Reunification and Other Pathways for Children 10.5.1 Reunification From the qualitative data, it appears that caseworkers based their decisions about reunification on their perceptions of the mother/parent’s attitude to the children These perceptions include the level of empathy a parent has for the child, and their level of insight into their child’s needs Their ability to engage effectively with their child was also assessed Caseworkers examined positive changes in the parent’s abilities to understand their children’s needs Improvements in the attachment bonds between parent and child throughout the contact visits were also scrutinised by workers This is consistent with prior research by Carlson et al (2008) where maternal readiness was identified as a key factor to successful reunification Similarly, this also reinforces previous research findings highlighting the importance of contact visits in facilitating reunification by strengthening parental attachment bonds (Berry et al 2007) Re-unification rates were higher for older children (2.38 times higher for five year olds compared to infants), a finding in accordance with prior research findings (Courtney and Wong 1996; Fanshel and Shinn 1978; Walton et al 1993; 146 10 Informing Policy and Practice in Reunification Connell et al 2006; Goerge 1990; Kortenkamp et al 2004; Wells and Guo 1999) and for parents who sought help from the program voluntarily Children who entered care for reasons of parental health had a higher rate of return than children whose parents had substance issues, perpetrated child abuse and domestic violence issues This also confirms prior research which states that parental substance abuse and domestic violence are factors which lower the odds of reunification (Shaw 2010; Choi and Ryan 2007) According to the risk typology evolved from the data based on the North Carolina Family Assessment Scale Reunification (NCFAS-R), three risk groups were identified 37.5 % of families fell into the high risk category, which indicates that they have lower than average scores on parental capabilities, family interactions and family safety Children in this risk group had a 73 % lower speed of reunification than the medium and low risk groups However neither the child’s gender nor source of referral made any difference to speed of reunification 10.5.2 Children in Particular Circumstances As discussed in the previous section, children whose parents had substance abuse issues had a substantially (86 %) lower return rate than children entering care for reasons of parental health Similarly, lower return rates were observed for children from families were abuse was the primary reason for entering care (83.0 % lower return rate compared to children whose parents had health issues) and children from families were domestic violence was the primary reason for entering care (73.0 % lower return rate) These findings of markedly poorer reunification rates by primary reason for entering care have important policy and practice implications It could be argued that substance abuse and addiction is often a chronic problem that any substance dependent person will battle with for most of their lives The theme of substance abuse leading to children being at risk of harm is again prevalent in past research Grella et al (2006) examine the issues associated with parental substance abuse programs undertaken when children have been taken into care These authors cite the need to tailor substance abuse programs to account for their role as parents in addition to their dependency issues These include recognising that for parents whose children have been placed in foster care, processing emotions such as guilt, sadness and loss is integral to effective recovery from addiction (Grella et al 2006:57) The fact that addiction recovery can be an “open-ended process” is often incommensurate with the demands of placement expediency enshrined by legislation (Grella et al 2006:58) Similarly, domestic violence may also need to be addressed in a different fashion As domestic violence is accompanied by systematic abuse of the victimised partner, numerous supports, and extended time may be needed to respond effectively Specifically, the dynamics of domestic violence which render women with a sense of powerlessness and diminished self-efficacy must be addressed by service providers if mothers are to be assisted in learning to care for their children 10.5 Child and Family Characteristics Associated with Reunification 147 adequately In essence, the effect of violence on the capacity for mothers to employ protective mechanisms around their children or even to comprehend the impact of witnessing violence on their children’s wellbeing has been widely established in the literature Caseworkers in this study spoke of women who feared seeking assistance for domestic violence as they also feared their children being removed This correlates with recent literature on domestic violence and child abuse, and legislation in NSW which requires child protection reporting when police attend a domestic violence incident in families with children aged less than twelve months (NSW Care and Protection Act 1998), (Richards 2011:5) However, it is plausible to infer that such a fear could be invoked by perpetrators of violence to ensure women remain compliant and silent (Humphreys 2007) Essentially what this indicates is the need for intervention that is mindful of both the clinical effects of domestic violence on both child and mother, in addition to the gendered nature of domestic violence Indeed, Humphreys states that there must be some recognition “that when children are affected by domestic violence, their protection is often linked to the protection of their mother” (Humphreys 2007:7) Younger children (under the age of 5) were less likely to be restored This can be attributed to their perceived vulnerability to risk of re-abuse and to the nature of attachment forming at this developmental stage of life Babies and infants form attachments as a matter of survival, and attachment to a caregiver occurs quickly However, this has implications for parents whose children have been removed at quite an early age The issue of attachment to temporary carers can also be an issue for children of other ages In the case example introduced in Chap. 7, children’s attachment to their mother waned due to their comparatively positive experience in the carer’s home and hence their reluctance to return home 10.6 Influence of Case Decision Making Elements and Service Variables 10.6.1 Reunification Outcomes As discussed in Chap. 6, patterns with regards to age, placement duration and child/familial circumstances impacted on reunification outcomes In terms of placement duration, reunification tended to vary, slow at the beginning of placement with the carer, but there was an increase in the rate of reunification between weeks 10 and 12 A moderate to slow rate of reunification manifested by week 41 During the period of the study, no reunification occurred after week 41 The pattern which emerges from the data clearly indicates that the chances of reunification are heightened during the first few months of entry into care Conversely, the findings also indicate that the chances of reunification are severely diminished the longer children are in care As previously discussed, this is in keeping with previous research, in relation to both the adverse consequences of rapid return 148 10 Informing Policy and Practice in Reunification (McDonald et al 2006) and extended time in care (Fernandez 1999; Fernandez and Delfabbro 2010) In the light of these findings, practitioners and policy makers may need to prioritise reunification in the early months of entry into care as well as improve the strategies for assisting children who have already experienced a longer duration in care The latter entails proactive social work practice in case planning, coupled with intense support services to enhance reunification chances for children who have been in care for an extended period of time Such an approach also draws upon previous research which emphasises the necessity of systematic case planning and goal setting for achieving reunification (Farmer et al 2011; Berrick 2009; Cleaver 2000; Farmer 1996; Bullock et al 1998; Aldgate 1980; Stein and Gambrill 1977) Planned case activity focused towards exit from care is necessary earlier on in the child’s placement careers, in order to reduce the risk of extended unplanned care periods and multiple placements The caseworker’s interview data on goal setting indicated the third most frequently identified goal was long term care or adoption set for children and families at entry to the program This may suggest caseworkers and statutory authorities tend to classify cases as non-restorable early on, rather than remaining genuinely open to the possibility of every family successfully changing, and in so doing, limit the potentialities for working with the family Caseworkers cited a number of interventions that needed to be implemented in order to improve parenting capacity A majority of parents needed to be referred to multiple services relevant to their particular issue Continuity in services was seen as vital, and the need to encourage some parents to consistently attend such services was also seen as vital Services included parenting courses, enhancing knowledge about the effects on children of domestic violence, neglect and substance abuse, drug rehabilitation, financial planning, counselling and enhancing housing stability The dearth of services available for birth families to address the problems which eventuate in care placement is commonly cited in research on reunification outcomes (Malucio and Ainsworth 2003) Previous studies highlight the correlation between successful outcomes and service variables, including the availability of concrete services, the creation of positive worker family relationships and the availability of various skills training to birth parents (Walton et al 1993; Lewis 1994) Other positive correlations include the nature of families’ support network, including the quality, reliability and size of this network (Festinger 1996; Fraser et al 1996) To reduce the structural risk factors which exacerbate problems for children and their families, it is essential to address the wider social-structural context in which these families live This entails addressing welfare arrangements, income support, housing, child care and health care Similarly, a structured approach which encompasses the delivery of support and parenting services is paramount Certain characteristics pertaining to contact, interventions and support, and the quality of relationship between carer and parent, caseworker and carer, and caseworker and parent also appear instrumental in reunification outcomes Previous research cites evidence which highlights the importance of caseworkers in facilitating reunification through supporting on-going contact with children and encouraging parental involvement in joint planning Contact has certainly been identified in prior research as an important factor in reunification Maintenance of 10.6 Influence of Case Decision Making Elements and Service Variables 149 contact between child and birth families and its subsequent impact on reunification outcomes has proven to be fertile ground for research (Cleaver 2000; Davis et al 1996; Pecora et al 2000; Bullock et al 1998; Delfabbro et al 2003; Fernandez 1996) Davis et al (1996) demonstrated in their study of 925 children, that contact visits were fundamental to reunification Moreover, once visitation plans were materialised, the chances of visits increased A majority of children who had contact with their parents as suggested by the courts were successfully reunified In this study, contact was viewed positively by all three parties, with caseworkers observing that contact between parents and child often enhanced the bond, without the added stress that caring for the child everyday contributed However, this was only effective if parents committed to contact by attending every allocated visit and engaging the child The location of contact was seen as vital Both carers and parents believed that contact in a Statutory Department office was not conducive to relaxed interaction between parent and child Parents reported feeling scrutinised and generally expressed a preference for contact to occur in the carer’s home or in a public environment This suggests that alternative venues for contact need to be explored If positive contact is a predictor of reunification, then it is essential that contact takes place in an environment that is less “artificial” and more supportive The relationship between carer and parent was also seen as crucial, and reiterates prior research that sees the establishment of strong carer-family and workerfamily relationships as crucial (Walton et al 1993; Lewis 1994) When the carer and the parent formed a relationship, the carer often modelled effective parenting techniques, which assisted the parents in learning good strategies for dealing with their children The relationship between parents and their caseworker was also seen as important Caseworkers who met regularly with parents were more likely to gain their trust Some parents contrasted their relationship with Agency caseworkers to the Statutory Department, with parents reporting that Agency caseworkers were more honest with them, and appeared to treat them with greater respect In circumstances where the relationship was strained, parents often believed their caseworker identified with the stance of the statutory authority and could therefore not be trusted Thus it can be surmised that a relationship premised on trust, mutual respect and negotiated guidance may be vital for enhancing the quality of decision making Ruch et al 2010; Fernandez and Maplestone 2006) Caseworkers, carers and parents expressed reservations about the extent of their participation in the process of decision making when it entailed the Statutory Department or the Children’s Court It is important to note here the limitations of the current study, which did not capture the perspectives of Statutory Department caseworkers or Children’s Court personnel on the challenges and constraints of the formal decision making process, nor directly evaluated actual communication strategies in that process Nevertheless, many parents felt somewhat excluded from the process of decision making, and felt confused by court processes which they did not feel they understood or could influence to their family’s advantage Similarly, carers expressed that they would like a greater voice in the final decision making process Intuitively, this latter desire would appear conducive to effective decision making, as carers spend a substantial amount of time with children and 150 10 Informing Policy and Practice in Reunification are often privy to more in-depth information on the child than formal authorities Similarly, some carers and parents reported frustration at the level of communication from the Statutory Authority 10.7 Implications for Policy and Practice The key implications for policy and practice are: • Re-prioritising resources to support reunification • Addressing the vulnerability of younger children entering care • Reducing entrenched structural risk factors • Fostering positive relationships • Increased specialist training and other support • A research agenda focused on generating ideas for practice for returning children to their parents The study findings highlight the need for a re-prioritisation of resources to support expedient reunification, where applicable As the majority of children who reunify so in the early months after entry, policy makers and practitioners must ensure that resources and caseloads are prioritised to maximize the potential for reunification and support for children and families More active social work practice and intensive supportive services are needed to effect reunification once children have been in care for an extended period of time Likewise, systematic case planning and goal setting for achieving reunification are essential The trend of children returning in the early months of placement should not, however, be construed as support for unplanned and speedy reunification at the expense of ensuring the children’s safety and best interests Further, in relation to preventive services for parents with infants and young children, the study findings show the need for a greater focus on the vulnerability of younger children entering care and remaining in care for extended periods within a more systematic case planning approach In terms of future research, there is a need to model reunification outcomes by stratifying samples into different age groups to better understand factors related to reunification based on age The study also highlights the need for reunification practice to be supported by effective structural interventions The Agency initiates many formal supports for TFC families, which are of demonstrable value to families, however, in addition to this macro interventions are needed to address the systemic and long-term entrenched social and economic disadvantages that many of these families face In order to reduce structural risk factors, it is crucial to respond to the structural dimensions of neglectful parenting and address the wider context of welfare arrangements, income support, housing, child care and health care This includes a structured approach to reunification supported with a package of services and comprehensive parenting support In terms of support from other services, domestic violence intervention, where this is required, should focus on both children and mother Empowering 10.7 Implications for Policy and Practice 151 the mother in a violent relationship will also facilitate protection of children Domestic violence counselling rather than relationship counselling should be provided in families where there is extreme violence Interaction with women’s health centres is a necessity Specific trauma counselling should be provided for parents who have experienced extreme childhood abuse themselves, in order to ameliorate the cycle of multigenerational trauma The findings show how the fostering of positive relationships is the cornerstone of effective reunification practices As parent–child contact is seen as a positive factor in enhancing reunification outcomes, if possible contact should take place regularly, and in an environment that is conducive to the repair and nurturing of relationships Building trust between caseworker and parent is essential, through honesty, open communication and establishing where appropriate caseworker independence from the statutory process To help make formal decision making processes more participatory and increase the likelihood of take up of support, parents could be provided with an advocate/liaison in the Children’s Court, separate to their legal counsel for court proceedings Agency caseworkers possess important case knowledge and expertise that can inform Children’s Courts in decision making processes Likewise carers spend the greatest amount of time with the child, care should also be taken that their perspectives are actively solicited in the court decision making process While the findings showed that carers benefit from the programme of training offered by the Agency, specialised carer training in reunification practices for all carers, and specific training for carers who look after children with high-level needs such as children who have experienced sexual abuse and are displaying extreme sexualised behaviours would enhance return stability Caseworker training could be strengthened by additional training on issues that can heavily impact on planning and implementing returns, for example, understanding of the dynamics and gendered nature of domestic violence, in order to assist mothers who may be engaging in self-defeating behaviours, as well as more in-depth understanding of the nature of multi-generational violence and childhood abuse Likewise this would assist front line workers to recognise why the characteristics and patterns of substance abuse recovery, are so often at odds with other pressures on a reunification timeline Research has a critical role to play in more clearly conceptualising and helping delineate reunification as a distinct domain of social work practice, as well as addressing critical gaps in empirical knowledge Most notably, reunification can create new challenges and stressors for families when children return need to be researched There is limited data on post reunification outcomes and this is a fertile area for future research This study, for example, did not address the phenomena of re-entry to care following reunification While valuable information on post-reunification outcomes (including recurrence of abuse) and re-entry to care are increasingly documented in an emerging body of research (Farmer et al 2011; Fuller 2005)—this can usefully be expanded Research should isolate high risk variables such as domestic violence and substance abuse, and examine the correlation between these variables and reunification rates within certain time periods Examining the 152 10 Informing Policy and Practice in Reunification relationship between barriers to reunification and types of services offered to families would assist with planning effective interventions and services There is also a need for research studies that tap the perspectives of fathers/father figures, which has been relatively neglected, partly due to the difficulties of accessing and engaging suitable samples Research could also be undertaken on the role carers and caseworkers have in formal decision making process in reunification matters As Farmer and her colleagues have recently observed in the UK, despite the evidence of a potentially high risk of failure, reunification has long been a neglected area in child welfare policy and practice, and suffers from not being recognised by policy makers and practitioners as a distinct domain of social work practice requiring sustained attention and research-based specialist knowledge to achieve effective outcomes (Farmer et al 2011) Taking the key findings of this study together, and in the light of the international evidence now available, it is demonstrable that much greater attention to good reunification practices greatly enhances outcomes for children’s wellbeing Conversely attempting to deal with the exacting demands of successful reunification assessment, planning and decision making without a systematic focus on evidence based practices diminishes the prospects for children in protective care of experiencing living at home with their birth parents safely As Berrick compellingly argues “time limited, concentrated reunification services put children and their birth parents at the centre of good child welfare practice” (2009: 117) which is precisely where they 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An analysis of unplanned and planned placement changes in foster care Children Australia, 36(2), 74–80 Walton, E., Fraser, M W., Lewis, R E., & Pecora, P J (1993) In-home family-focused reunification: An experimental study Child Welfare, 72(5), 473–487 Wells, K., & Guo, S (1999) Reunification and re-entry of foster children Children and Youth Services Review, 21(4), 273–294 Wulczyn, F (2004) Family reunification The Future of Children, 14(1), 94–113 ... nature E Fernandez, Accomplishing Permanency: Reunification Pathways and Outcomes for Foster Children, SpringerBriefs in Well-Being and Quality of Life Research, DOI: 10.1007/97 8-9 4-0 0 7-5 09 2-0 _2,... 13 Elizabeth Fernandez University of New South Wales Sydney NSW Australia ISSN 221 1-7 644 ISBN 97 8-9 4-0 0 7-5 09 1-3 DOI 10.1007/97 8-9 4-0 0 7-5 09 2-0 ISSN 221 1-7 652 (electronic) ISBN 97 8-9 4-0 0 7-5 09 2-0 ... in Well-Being and Quality of Life Research For further volumes: http://www.springer.com/series/10150 Elizabeth Fernandez Accomplishing Permanency: Reunification Pathways and Outcomes for Foster