Assignment Task
Activity
Adam is two years old and has a history of serious ‘faltering growth’ or ‘non- organic failure to thrive’ with no medical cause having been found for his poor weight gain. He is significantly behind in his motor and cognitive developmental milestones, and his language skills are very poor. Statutory child protection services have confirmed that Adam is suffering from neglect and ‘cumulative harm’. There is an application before the court for an order to require the family to receive ongoing supervision and monitoring of Adam’s condition. The identity of his father is unknown. Adam’s mother, Alice, is 23 and is six months pregnant. She spent most of her childhood in State care and experienced multiple foster placements. Alice lives with her boyfriend Robert, who is the father of the baby she is expecting. Robert is unemployed and is on probation for drug-related offences. Alice appears depressed and anxious and seems very emotionally dependent on Robert. They live in private rental accommodation in a large rural town and have no extended family support. A range of services is involved with the family (child and family health nurse, childcare centre, non-government family support service, general practitioner, drug and alcohol treatment service, correctional services and statutory child protection services).
In a small group, explore the current and future needs of Adam and his family and consider the part each of the services involved may play by having these various services represented by different individuals or subgroups in the group. How may the services work together to assist Adam and his family? What may be the personal, professional and organisational challenges you could face in working together with this family? What may each practitioner need to fulfil their role to the best of their ability?
Conclusion
The current policy environment offers some exciting opportunities to redevelop professional roles and services so that they are more holistic and individually tailored to families’ needs. There is increasing recognition that organisations need to work together, especially for families with multiple and complex needs. This is not just a matter of exhorting people to do so – that is much the same as saying to a troubled
40 Working with Vulnerable Families.
Contemporary policy context
As the close relationship between problems such as poverty, mental illness, homelessness, substance misuse, unemployment, crime, antisocial behaviour, poor health, low literacy and child abuse and neglect is increasingly understood, new ways of thinking and responding to this challenge are emerging. Developing systems and funding models that get beyond the fragmentation and duplication created by ‘single input services based on categorical funding’ when trying to serve individuals and families with multiple and complex needs is a major challenge. At the service delivery level, a related challenge is how to tailor services to meet the individual needs of specific families and give the consumers of services a greater involvement in decisions about how these services are delivered; in short, how do we keep the family, and not the service, at the centre of what we do? In countries such as the UK and, more recently Australia, ‘social inclusion” policies have provided an overarching framework for understanding and responding to ‘socially marginalised’ individuals, families and communities. Hayes, Gray and Edwards (2008) describe the three commonly accepted forms of social exclusion as:
Learning goals
Understand
Current policy directions that are supporting more holistic approaches to working with vulnerable families who have multiple and complex needs.
Identify
The practitioner, organisational and policy related factors that shape practitioner roles.
Consider
The potential for broadening practitioner roles so that they are more holistic and family centred.
Understand
The importance of working across professional and organisational boundaries and the factors that influence this.
Be Able To Accept
Effectively manage the conflict that can occur in working across professional and organisational boundaries.
Introduction
With the growing realisation that many varied and complex problems, from W global warming to crime, infectious diseases, and child abuse and neglect, cannot be solved by one service sector or ‘silo’, there is an increasing momentum for ‘joined up’ approaches to tackle such issues. In relation to socially marginalised people, overarching ‘social inclusion’ policy frameworks in some countries are focusing attention on how sectors such as health, education, housing, employment and social services can work together more effectively.This has two main implications for practitioners working with families that have multiple and complex needs:
Reflective Questions
Think about high-risk situations that may arise in relation to mental health, domestic violence or child protection issues. What might help practitioners deal with the anxiety such situations arouse so that safety can be maintained and inter- agency relationships not weakened? Can you think of a situation like this where people in different organisations managed to work together more effectively than one might have expected? What might have made this possible? Are there any lessons that can be learned from this example?
Activity
Adam is two years old and has a history of serious ‘faltering growth’ or ‘non- organic failure to thrive’ with no medical cause having been found for his poor weight gain. He is significantly behind in his motor and cognitive developmental milestones, and his language skills are very poor. Statutory child protection services have confirmed that Adam is suffering from neglect and ‘cumulative harm’. There is an application before the court for an order to require the family to receive ongoing supervision and monitoring of Adam’s condition. The identity of his father is unknown. Adam’s mother, Alice, is 23 and is six months pregnant. She spent most of her childhood in State care and experienced multiple foster placements. Alice lives with her boyfriend Robert, who is the father of the baby she is expecting. Robert is unemployed and is on probation for drug-related offences. Alice appears depressed and anxious, and seems very emotionally dependent on Robert. They live in private rental accommodation in a large rural town and have no extended family support. A range of services is involved with the family (child and family health nurse, childcare centre, non-government family support service, general practitioner, drug and alcohol treatment service, correctional services and statutory child protection services). In a small group, explore the current and future needs of Adam and his family and consider the part each of the services involved may play by having these various services represented by different individuals or subgroups in the group. How may the services work together to assist Adam and his family? What may be the personal, professional and organisational challenges you could face in working together with this family? What may each practitioner need to fulfil their role to the best of their ability?
Reflective Questions
Can you think of an example of inter-organisational conflict where interpersonal factors exacerbated or reduced the level of conflict? What are the values and skills that a practitioner needs to work effectively across organisational boundaries?
Intrapersonal level of analysis
Working with vulnerable children and families can be very distressing and can evoke painful feelings for service providers. In the face of strong emotions it is common for defence mechanisms, such as projection and displacement, to come into play. This can intensify inter-agency and inter-professional tensions, and lead to destructive levels of conflict. In a study of inter-agency conflict in a child protection context, it was most intense in those cases in which practitioners felt impotent to protect a vulnerable child (Scott, 1997).
For example, when child neglect was a long-standing problem in the family, or when there were suspicions but little evidence that a child had been sexually abused, deep emotions were aroused in all of the practitioners involved. Each sincerely believed that it was beyond their organisation’s ability to protect the child, but some strongly believed that another service had the power to do so, even when there was little rational basis for this view. While this may relate to a lack of understanding of the capacities and constraints of other organisations, another explanation is that we sometimes cope with strong feelings such as anger and guilt by projecting responsibility or displacing hostility onto others.
In another study that explored the attitudes of different professions to child sexual abuse vignettes, responses were contrary to those expected by professional stereotypes, leading the researchers to comment: