FAMILY THERAPY, FAMILY PRACTICE AND CHILD AND FAMILY POVERTY

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FAMILY THERAPY, FAMILY PRACTICE AND CHILD AND
FAMILY POVERTY

• HISTORICAL PERSPECTIVES AND RECENT DEVELOPMENTS

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• HARVY FRANKEL, M.S.W., Ph.D., ASSOCIATE DEAN AND
  ASSOCIATE PROFESSOR, FACULTY OF SOCIAL WORK,
  UNIVERSITY OF MANITOBA
• SID FRANKEL, M.S.W., Ph.D., ASSOCIATE
  PROFESSOR, FACULTY OF SOCIAL WORK, UNIVERSITY OF
  MANITOBA

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CONTENTS

• RELATIONSHIP OF SOCIAL WORK TO FAMILY THERAPY
• AMBIVALENT RELATIONSHIP OF FAMILY THERAPY WITH
  POVERTY
• INTERSECTION WITH CAUSE VERSUS FUNCTION DEBATE IN
  SOCIAL WORK
• DEFINITION, MEASUREMENT AND DEVELOPMENTAL
  SEQUALAE OF POVERTY

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CONTENTS CONTINUED

• FOUR PROMISING MODELS DESIGNED FOR FAMILIES
  LIVING IN POVERTY
• COHERENCE OF MODELS WITH SOCIAL SCIENCE
  LITERATURE
• IMPLICATIONS FOR FAMILY CENTRED PRACTICE

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RELATIONSHIP OF SOCIAL WORK TO FAMILY THERAPY

• THE ROLE OF SOCIAL WORK IN FAMILY SERVICES CAN BE
  TRACED TO AT LEAST 1869, WHEN THE CHARITY
  ORGANIZATION SOCIETY WAS INITIATED
• THE TERM FAMILY-CENTRED PRACTICE
• EMERGED IN THE 1950S
• SOCIAL WORKERS WERE WELL REPRESENTED AMONG FAMILY
  THERAPY PIONEERS IN THE 1950S
• FAMILY THERAPY BECAME AN IMPORTANT COMPONENT OF
  FAMILY SOCIAL WORK AND SOCIAL WORK EDUCATION

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AMBIVALENT RELATIONSHIP OF FAMILY THERAPY TO
POVERTY

• PROBLEM OF POVERTY HAS BEEN AT HEART AND CORE OF
  SOCIAL WORK
• CONVERSELY, FAMILY THERAPY HAS AN AMBIVALENT
  HISTORICAL RELATIONSHIP WITH POVERTY
• ONE MAJOR SCHOOL DEVELOPED FOR URBAN POOR
  FAMILIES
• EFFECTS OF SOCIAL ENVIRONMENT ACKNOWLEDGED
• BUT, MAIN FOCUS HAS BEEN ON INTRA-FAMILIAL
  FACTORS TO THE NEAR EXCLUSION OF POVERTY
  ENVIRONMENTS

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CAUSE VERSUS FUNCTION

• HISTORIC CONCERN WITH POVERTY COMBINED WITH
  DEBATE ABOUT PROFESSIONAL ROLES
• CAN CAUSE (REFORM) BE COMBINED WITH FUNCTION
  (SERVICE)?
• LEE CAUSE IS NATURALLY TRANSFORMED INTO
  FUNCTION AND THEY SHOULD NOT CO-EXIST
• SCHWARTZ CAUSE AND FUNCTION MUST BE COMBINED AS
  PRIVATE TROUBLE IS ONLY A SPECIFIC EXAMPLE OF A
  PUBLIC ISSUE
• SPECHT AND COURTNEY SOCIAL WORKERS HAVE BECOME
  UNFAITHFUL ANGELS AS THEY HAVE BEEN DIVERTED FROM
  SOCIETAL PERFECTIBILITY TO PSYCHOTHERAPY

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DEFINITION OF POVERTY

• CONTESTED ON POLITICAL AND IDEOLOGICAL GROUNDS
  DESPITE SIGNIFICANT BODY OF THEORY AND RESEARCH
• STANDARD OF LIVING AT THE BOTTOM OF
  SOCIO-ECONOMIC STATUS HIERARCHY
• INCOME
• EDUCATIONAL ATTAINMENT
• OCCUPATIONAL TYPE
• RESIDENTIAL LOCATION

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DEFINITION OF POVERTY

• GENERALLY CONSTRUCTED ONLY AS FLOW OF INCOME INTO
  A FAMILY
• NOT VARIATIONS IN FINANCIAL DEMANDS
• NOT VARIATIONS IN ASSETS

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ESTABLISHING THE POVERTY LINE

• ABSOLUTE VERSUS RELATIVE MEASURES
• ABSOLUTE
• GOAL OF PHYSICAL SUBSISTENCE (EXPERT NORMS)
• NO REFERENCE TO SOCIAL AND CULTURAL NEEDS
• SUBSISTENCE DEFINED RELATIVE TO NATIONAL AND
  CULTURAL STANDARD

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RELATIVE POVERTY

• GOALS
• SOCIAL ROLE PERFORMANCE
• PARTICIPATION IN SOCIALLY SANCTIONED
  RELATIONSHIPS AND ACTIVITIES
• ADHERENCE TO CULTURALLY SANCTIONED BEHAVIORAL
  NORMS

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MEASUREMENT OF POVERTY

• OBJECTIVE VERSUS SUBJECTIVE
• OBJECTIVE
• ABSOLUTE COST OF MARKET BASKET OF ESSENTIAL
  GOODS AND SERVICES IN RELEVANT MARKET
• RELATIVE
• PERCENTAGE OF MEDIAN INCOME
• HIGHER THAN AVERAGE EXPENDITURES ON BASIC
  NECESSITIES

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SUBJECTIVE MEASURES OF POVERTY

• BOTH ABSOLUTE AND RELATIVE
• PUBLIC PERCEPTIONS SOCIETAL RATHER THAN EXPERT
  DEFINITION
• DEPRIVATION INDEX OF SOCIALLY PERCEIVED
  NECESSITIES

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IMPACT OF POVERTY ON CHILDREN

• ELEVATED RISK FOR WIDE RANGE OF DELETERIOUS
  DEVELOPMENTAL OUTCOMES
• PHYSICAL
• EMOTIONAL
• COGNITIVE
• SOCIAL
• EDUCATIONAL

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SOURCES OF DEVELOPMENTAL EFFECTS

• SOCIETAL DISCRIMINATION AND STIGMATIZATION
• MATERIAL RESOURCES
• COMMUNITY AND NEIGHBOURHOOD
• FORMAL INSTITUTIONS
• INFORMAL GROUPS

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NEIGHBOURHOODS AND COMMUNITIES

• MIXTURE OF PROTECTIVE AND RISK FACTORS
• PROTECTIVE SOCIAL SUPPORT
• RISK AMOUNT OF ECONOMIC INEQUALITY

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ROLE OF FAMILIES

• FAMILY STRESS THEORY
• FAMILY INVESTMENT THEORY
• ROLE MODEL THEORY
• WHAT MONEY CANT BUY PARENTAL FACTORS
  INDEPENDENTLY CONTRIBUTE TO UNEMPLOYMENT AND POOR
  PARENTING

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PATHWAYS OF EFFECTS OF POVERTY

• MATERIAL
• PSYCHOSOCIAL
• BEHAVIOURAL

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PATHWAYS
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EXEMPLARY MATERIAL PATHS

• POOR NUTRITION
• HOME ENVIRONMENTS WITH LIMITED STIMULATION
  OPPORTUNITIES
• DELETERIOUS PREGNANCY OUTCOMES
• EXPOSURE TO DISEASE AGENTS IN PHYSICAL ENVIRONMENT

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BEHAVIOURAL PATHWAYSAN EXEMPLARY MEDIATING
BEHAVIOUR

• HIGH RATES OF SMOKING
• RESPONSE TO POVERTY ENVIRONMENTAL FACTORS
• RELATED TO MORBIDITY FOR SEVERAL DISEASES
• ESPECIALLY AMONG ADOLESCENTS AND SINGLE MOTHERS
  LIVING IN POVERTY

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PSYCHOSOCIAL PATHWAYS

• BROAD EFFECTS OF POVERTY ON MULTIPLE ENVIRONMENTS
  EFFECTING CHILDREN
• INTERACTION BETWEEN PARENTS AND OTHER ADULTS
  CAN IMPROVE PARENTING THROUGH SOCIAL SUPPORT
• INTERACTIONS BETWEEN PARENTS AND CHILDREN CAN
  BE NEGATIVELY EFFECTED
• BALANCE OF NEIGHBOURHOOD RISK AND PROTECTIVE
  FACTORS

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AN EXEMPLARY PSYCHOSOCIAL PATHWAY

• INCOME POVERTY
• FINANCIAL STRAIN
• PERCEPTION OF DISORDERED AND NEGLECTFUL
  NEIGHBOURHOOD ENVIRONMENT
• INCREASED PARENTAL ANXIETY, DEPRESSION AND ANGER

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AN EXEMPLARY PSYCHOSOCIAL PATHWAY

• INCREASED NEGATIVE PARENTING BEHAVIOUR AND
  DECREASED POSITIVE PARENTING BEHAVIOUR
• POOR ADOLESCENT ADJUSTMENT

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A CHILDS VIEW OF RESOURCES AND PROTECTIVE
FACTORS

• FUNCTIONAL FAMILY RELATIONSHIPS
• FRIENDLINESS OF NEIGHBOURS

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FOUR FACTORS FROM POVERTY LITERATURE THAT
FAMILY THERAPY SHOULD INCORPORATE

• MATERIAL CIRCUMSTANCES
• FAMILYS COPING AND STRESS MANAGEMENT CAPACITIES
• ASSIST PARENTS TO MAINTAIN GOOD RELATIONS WITH
  NEIGHBOURS AND COMMUNITY MEMBERS
• PARENTAL MENTAL HEALTH

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PROMISING MODELS
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Congruence of Promising Models With Selected
Findings from the Social Science Literature on
Poverty
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CONGRUENCE WITH SOCIAL SCIENCE LITERATURE
CONTINUED
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CAUSE AS WELL AS FUNCTION?

• FAMILY THERAPIST INVOLVEMENT IN SOCIAL CHANGE
  ACTIVITIES
• JUST THERAPY
• THERAPISTS AS THERMOMETERS OF PAIN SHOULD
  INFLUENCE PUBLIC OPINION FOR POLICY CHANGE
• THERAPISTS ARE ALSO INVOLVED IN COMMUNITY
  DEVELOPMENT, POLICY ADVOCACY AND POLICY RESEARCH
  AS PART OF THEIR JOBS
• COMMUNITY FAMILY THERAPY FOCUSES ON SOCIAL ACTION
  AT THE LOCAL LEVEL AND NOT STRUCTURAL CHANGE
• SYSTEMS ORIENTED FAMILY-CENTRED APPROACH FOCUSES
  ONLY ON AGENCY AND SERVICE SYSTEMS CHANGE

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CAUSE AS WELL AS FUNCTION

• MULTILEVEL SYSTEMS MODEL
• COMBINATION OF PROFESSIONAL AND CITIZEN
  OBLIGATION
• PUBLIC EDUCATION
• AGENCY POLICY AND PROCEDURAL CHANGE
• INFLUENCE PROFESSIONAL ASSOCIATIONS
• RESEARCH
• SUPPORT DEVELOPMENT OF COMMUNITY-BASED FAMILY
  SUPPORT PROGRAMS

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SELECTED ASPECTS OF FAMILY-CENTRED PRACTICE

• ALLEN AND PETR (1998)
• STRENGTHS-BASED PERSPECTIVE
• EMPOWERMENT ORIENTATION
• RESPECT FOR DIVERSITY

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Systems Oriented Just Therapy
Multi-Level Community Family
Family-Centred
Systems
Therapy
Approach
Therapy
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Systems
Oriented Just Therapy
Multi-Level Community Family

Family-Centred
Systems
Therapy
Approach
Therapy