Family support after reunification

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Family support after reunification

• Wales College Development Group 2006

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The reality of return home

• Too often its not a planned outcome with active
  social work.
• Too often its due to
• - placement breakdown or run away
• - pressure from parents, family or child/YP
• - case planning loses momentum
• fait accompli for
  the SW. Quote 1
• Too often theres no change in the child/YPs
  behaviour (only 13 beyond parental control
  returned because of a change in their behaviour).

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The reality of return home

• Too often no resolution of family problems (eg.
  lack of support, poverty, MH, SM, poor parenting
  skills). Key problems of birth families tend to
  remain despite their childs absence in the care
  system. (Sinclair et al)
• Too often the risk of re-abuse or neglect not
  addressed (eg. 42 fostered children who returned
  home re-abused within 3 years).
• Often family changes. Quote 2
• Emotional climate of the family is crucial to
  psychosocial outcomes (eg. remaining in care /
  adoption is better if pervasive family
  quarrelling and disharmony). Quotes 3 and 4

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A revolving door?

• High rates of re-entry to care (eg. 54 within 2
  years, 37 those in foster care within 3 years).
• Oscillating - with 2, 3 or 4 reunions.
• More likely for those who return home rapidly (as
  opposed to remaining in care for longer).
• More likely for primary school age children (as
  opposed to younger or older).
• Re-entry not necessarily a failure.
• But early reunion swift re-entry poor
  assessment or lack of follow-up support?

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So

• The assumption that reunification is best is
  not true if birth family issues or child/YP
  behaviour have not been addressed.
• Indeed, return home may be very risky for some.
• Other options on the spectrum need to be actively
  considered (eg. remain in foster care but with
  significant / frequent contact, shared parenting)

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Is support provided?

• Purposeful planning does not necessarily lead to
  resources and support after reunification.
• In a sample of reunified children under 13 years,
  14 returned to care within 9 months. Prevalence
  in this group of returned home early with no
  follow-up support.
• Follow-up support is often patchy 1 in 4
  children had contact with a SW after return.
• Only 1 in 6 reunified foster children getting
  active SW support (Sinclair et al).
• When provided, its often for short periods,
  tails off and focuses on practical tasks (ie.
  less support than when in stable accommodation).
• Reasons shortage of SWs? (US study of 62
  reunions) or managers rating the priority low?
  (Sinclair et al).

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Does support make a difference?

• Research shows effective ongoing social work can
  make the difference between success and failure
  in reunification.
• But we failed to find any form of help that
  statistically affected outcomes. (Sinclair et
  al)
• ie. theres little evidence about how the
  nature, intensity and duration of services
  provided affects patterns of re-entry to care
  following reunion.

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Basic determinants of good outcomes from
reunification

• Sinclair et al identify the following factors as
  those that best determine the success of
  reunification
• Quality of parenting action needed to improve
  this
• School experiences intervention with the school
  is crucial to support reunification
• Motivation of the parent and child - families
  need to be determined to make the return work,
  irrespective of any practical difficulties.

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Specialist reunification services

• These services operate both before and after
  reunification.
• Are effective if
• - families receive interventions that resolve
  the problems
• that originally lead to the entry to care
• - goal achievement measures are agreed for
  parents and
• children
• - behavioural interventions are used as part of
  a
• repertoire of approaches.

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Specialist reunification services a case study
(1)

• An American service called FRS
• intensive follow-up after return to address
  issues that might lead to re-entry (up to 90 days
  total)
• goal setting (eg. parenting skills, anger
  management, school attendance/results, conflict
  resolution)
• referral to support services (eg. drug treatment)
• arrange informal ongoing supports
• low caseloads (6 vs 22).
• RCT results
• 93 FRS clients home within 90 days (vs 28)
• 75 FRS clients at home 1 year later (vs 49)

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Specialist reunification services a case study
(2)

• So, FRS helps to reunify some children who would
  not otherwise return home and to support them in
  remaining there.
• But .
• 15 months later, 21 FRS clients had returned to
  care (vs almost the same number - 17).
• was return was precipitate for some children?
  .was return the right outcome for some
  children?
• and no data about the outcomes for children or
  families (eg. psychosocial functioning, parental
  stress, problem behaviours).

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Support needs to start before reunion

• The chances of successful reunion are much
  greater where
• there are continuities in the childs life (incl.
  family relationships, education, cultural
  identity, social networks)
• the chid retains a role within the family at each
  stage in the return process
• the child retains territory (eg. by having a room
  or bed, by leaving toys or having keepsakes
  retained).
• Bullock, Gooch Little (1998)

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Support after reunion (1)

• Families often need the greatest support at the
  time when the social worker may feel their work
  is done and withdrawal is an appropriate
  strategy. Quote 5
• But families want help without intrusion,
  judgments, feelings of being watched. (Sinclair
  et al)
• Formal plan to make the return work successfully
  should also predict possible problems and include
  a contingency for these challenges, ie active
  management of risk.
• The family should be instrumental in shaping this
  plan (possibly through a FGC) and be committed to
  its implementation.

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Support after reunion (2)

• Even the most successful reunion will be highly
  emotionally-charged (some mothers have compared
  the reunion to the birth of a new child). Quotes
  6 and 7
• The strength of emotion may take all by surprise,
  but not all participants might be ecstatic. Quote
  8
• Many parents do not have the skills to examine
  these feelings and to empathise with the
  anxieties and needs of others. Family members may
  need help in this area eg. counselling and a
  chance to talk things over (Sinclair et al) or
  formal reconciliation or mediation to aid family
  communication.

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Support after reunion (3)

• Initial honeymoon period. Quote 9
• The family needs to be prepared for the anxiety
  generated by return, the disputes that are likely
  to occur (eg. about territory and role) and the
  expectations that will not be met. Rows often
  encapsulate a range of deeper tensions. Quotes 10
  and 11
• Talking to other families who have been through a
  successful reunion may help.

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Reported problems after return

• jealousy of other siblings
• managing travel to school
• getting used to having the child/YP around
• childs mood swings
• accommodation problems
• financial problems
• work problems
• family tensions
• attachment issues
• (Sinclair et al)

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Support after reunion (4)

• Extra expenses, responsibilities, logistical
  problems (eg. getting the child safely to school,
  looking after their health) and practical care
  tasks need to have been assessed and planned.
  Quote 12
• Marking the return home in a way which involves
  all family members (including new family members
  who have arrived since the separation such as
  step-parents/siblings) can be an important rite
  of passage.

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Support after reunion (5)

• For children over the age of 11, the family
  should be prepared for the fact that the YP is
  also returning to a wider social network outside
  the immediate family (eg. community activities,
  school, old friends and peer groups). These
  transitions are delicate and require careful
  negotiation. The family needs to be supported to
  allow the young person to establish a role
  outside the family that is complementary to their
  role in the home.
• It is important that families have adequate time
  to adjust. The process may take a long time.

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Support after reunion (6)

• Suggestions from Sinclairs interviewees
• Foster carers might be used more often to support
  mother and child/YP, and for respite care (ie.
  mothering mothers, an extra sister, being a
  safety net at times of crisis, access to ordinary
  enjoyable experiences).
• Access for children/YP to adults whom they trust
  and can talk to on a regular basis as part of
  their ordinary lives (eg. education SW,
  counsellor, former carer)

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Support after reunion (7)

• Parental training in how to deal with teenagers.
• Clarity about what each side expects if the
  child/YP returns home what parents need to put
  in place (so good progress in the placement is
  built on) and what support they will receive.
  More consideration of voluntary care orders as
  an option.

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Resources to help

• The Going Home checklists
• Advice for parents and carers on the 5 stages of
  reunion (prepared with the Family Rights Group)
• Others?