JOURNAL ISSUE 4
2001/2002

table of contents | abstracts

 

Bemidji State University
College of Social and Natural Sciences
Social Work Program
Dr. Dada M. Maglajlic'

 

 

INTRODUCTORY REMARK

Since 1985 the number of reports of child abuse and neglect has risen by 50 percent. Among reasons cited as contributing to this increase are greater public awareness, more families living at or near the poverty level, abuse of alcohol and other substances and fewer resources available to the increasing number of families needing child protective services.

In 1993 an estimated 1,299 child abuse and neglect related fatalities were confirmed by child protective agencies in the United States. At least three children died each day as a result of maltreatment. The cause of death for 51 percent of victims was abuse, 43 percent of deaths were the result of neglect, and 6 percent of the fatalities were caused by a combination of abuse and neglect. Young children were most often the victims of these fatal injuries, with 86 percent of deaths occurring when children were under the ages of five. 46 percent of these victims were under the age of one at the time of their death. Breakdown by the type of abuse indicates the following: 1,404,830 cases of neglect (47 percent), 896,700 cases of physical abuse (30 percent), 328,790 cases related to sexual abuse (11 percent), "other" - that is more than one form of neglect and/or abuse was present in 269,010 cases (9 percent), and 59,780 cases of emotional abuse (2 percent).

/Graph 1. - Source: NNCAN, 1994/

The child abuse and neglect crisis in the King and Pierce Counties (state of Washington) corresponds to the crisis at the national level. Although we served all four major ethnic minority groups, as well as the majority population, this project was specially designed to empower Hispanic/Latino families. The total population of King County is 1,507,319, while the Latino population is approximately 70,000; the total population of the Pierce County is 586,203 while there are over 32,000 Latino residents. About 50 percent of the Latinos in the target area are undocumented. The vast majority are low income, with family resources well below the poverty line and public income support playing a significant role in family economic survival. Unemployment and underemployment, substance abuse, low formal educational attainment and cultural anomie are typical for these high need - low resource families. Among the 15 risk factors commonly acknowledged to be correlated with substance abuse tendencies, all are present to some degree in the Latino community, including family management problems, academic failure, economic and social deprivation, transition and mobility.

The link between substance abuse and child abuse has strengthened over the years. Parental abuse of alcohol and use of other drugs has been identified as a major factor contributing to child maltreatment and death (Eigen, 1991). Flanzer and Sturke (1987) found a positive correlation between alcohol abuse by parents and maltreatment of their children 11-20 years of age.

The National Committee for the Prevention of Child Abuse (NCPCA, Washington D.C., 1992) estimates that 10 million children in the United States are being raised by addicted or alcoholic parents, and at least 675,000 children each year are seriously mistreated by an alcoholic or drug abusing person. Another estimate reported by the same source is that at least 11 percent of pregnant women nationwide are using illegal drugs. Prenatal exposure to alcohol is noted to be the major cause in birth defects.

Ackerman (1988) argues that any alcoholic family is abusive since alcoholism is an abuse in itself. Brown (1988) found a significant correlation between alcohol abuse and child sexual abuse; half of those who commit sexual abuse also abuse alcohol. Murphy and associates (1991) studied the relationship between substance abuse and serious child maltreatment; at least one parent misused either drugs or alcohol in 43 percent of the cases they studied.

Research related to the use of alcohol and drugs among different ethnic groups in the United States suggests that the substance abuse may be less related to ethnicity than to demographic and structural factors influencing families. In their research on ethnic high-risk families, Jones and DeMaree (1975) concluded that social and environmental conditions such as poverty, prejudice, unemployment, frequent family moves, low educational level and community crime levels are intricately interrelated with family functioning. These structural factors, often beyond the control of family members, contribute to family disruption, overcrowding, stress and depression leading to parent-child conflict and hostility (Conger, 1992; Kumpfer, Alverado, Turner, & Griffin, 1993).

Physical abuse and neglect are more likely among people in poverty. Although child abuse occurs in all racial, ethnic, cultural and socioeconomic groups, high rates of poverty among ethnic minorities present an additional contributing factor. This is probably why minority children enter the child protection system in disproportionately large numbers (Bays, 1990).

Howard and Associates (1989) describe seven years of efforts to reach, assist and understand substance-abusing families and their young children; following are some conclusions regarding serving these families, the characteristics of these families and the impact on children living in substance-abusing families:

a.) substance abusing parents are unstable, move frequently, lack telephones, fail to keep appointments and drop out of sight when abusing illicit drugs;

b.) substance abuse undermines normal patterns of interaction and alters conventional priorities in that parents who are addicted to drugs have primary commitment to chemicals, not to their children;

c.) safety is an issue for family members, for professional staff who make home visits and most of all for the children of substance-abusing families since the substance abusing parent is often unable to assume a primary protective role;

d.) turnover in program staffing interferes with the formation of nurturing, non- threatening relationships with substance abusing families.

Zill (1993) is of the opinion that it is important to look at the realities of how families are actually functioning, rather than labeling some types of families as inevitably bad and others as invariably good. His review highlighted the need for family-level interventions to enlist the family's support in creating an enduring family environment that is conducive to the prevention of substance abuse, and even further to the prevention of the child neglect and/or abuse.

Polansky and Associates (1991) are of the opinion that parents who neglect their children differ from parents who don't: although there is a strong relationship between poverty and neglect, not all parents who are poor neglect their children. Parents who neglect and/or abuse their children are more isolated, have fewer relationships with others, are less able to plan, less able to control their impulses, are less confident about the future and are more plagued with physical and psychological problems. They are also more likely to say that they never received love and were unwanted by their parents; many of them have been raised by relatives or in foster care, they often began life lonely and continue to live in isolation, they also have difficulty identifying neighbors or friends with whom they could leave their children if they needed emergency child care or from whom they could borrow a few dollars in an emergency.

We are of the opinion that comprehensive, long-term community support services which take into account any/all available positive (strength) elements at all three levels (individual/family - neighborhood - community) present an effective solution to the problem.

 

EMPOWERMENT PROJECT

"To be committed to an empowerment agenda is to be committed to identify, facilitate or create contexts in which heretofore silent and isolated people, those who are outsiders in various settings, organizations and communities gain understanding, voice and influence over decisions that affect their lives" (Rappaport, 1990).

Our agency was providing comprehensive social services to some 4,700 members of the target area annually, 40 percent of whom were under age 18; this includes comprehensive substance abuse prevention and outpatient treatment programs. Overall we estimated that 75 percent of our clients faced substance abuse challenges in their lives, with alcohol being the primary concern. There is a recognized strong relationship between child abuse and neglect and the caretaker's substance abuse. This correlation is evident in the target area, where the State Division of Child Protective Services reports a dramatic 55 percent increase in the number of child maltreatment cases reported to King and Pierce Counties with cases going from 17,044 in 1990 to 26,440 in 1992. According to the State Research and Data Analysis Department, the number of people receiving Aid to Families with Dependent Children (AFDC) increased by 16 percent during the period from 1990 to1992, which is an 8 percent annual growth rate. During the same period, the number of children receiving AFDC increased by 28 percent, which is a 12 percent annual growth rate.

On an individual person or family level, an empowerment orientation allows the social worker to view the helping process as a partnership in which both the worker and the individual or family are involved in mutual assessment of problems in functioning and definition as well as problem solving. The focus of the helping process is on people's strengths, adaptive capacities and potentialities (Saleebey, 1992).

The empowerment approach to social work practice helps social workers to respect people's strengths and attempts to cope: this approach supports and reinforces the notion that people are capable of assuming control over their lives and can adapt and cope with the negative affects of social change.

Through the empowerment process, an individual and/or a family with a problem discovers the power within and learns how to resolve the problem(s) or satisfy needs (Rose, 1990). Through our empowerment program, legal, educational, case-management and many other services were offered to H/L families with substance abuse and other problems.

 

GOALS AND OBJECTIVES

The overall goal of the project was to conduct community based comprehensive and coordinated prevention and intervention activities to reduce and prevent the maltreatment of children in Latino substance abusing families within King and Pierce Counties in western Washington. The following objectives were specifically defined:

1.) To prevent and/or reduce incidence of maltreatment of children in substance abusing families by means of written information, structured group process, individual intervention and follow-up involving children, parents, other family members, professionals and the community at large.

2.) To prevent and reduce the incidence of abuse and neglect of children in Latino substance abusing families by means of family- and community-based education and intervention services.

3.) Provide for project replication by wide dissemination of the project related outcomes and other materials throughout the professional community involved in child abuse and neglect issues, as well as substance abuse prevention and treatment.

4.) Promote family unification and reunification.

5.) Provide follow-up and after care for six months (minimum three months) after the completion of the intensive six month "wraparound" intervention.

6.) Most importantly, neighborhood support centers will be established as a form of support for all members of the family (children, parents).

7.) As part of the support services, a special help-line was introduced, available 24 hours a day.

 

APPROACH

In the Latino culture, the family tends to focus inward for emotional and financial support whereas the majority culture expects families to seek help from government agencies and community services. The Latino family structure assigns traditional roles for family members in an authoritarian decision-making structure. Typically, the oldest female is expected to care for her younger siblings, while the oldest male is expected to assume the father's role of provider in his absence. This compares to a generally more democratic process among Anglo families. Such differences are compounded by many Latino families who have limited opportunities to learn and use English as their primary language. In such families, however, children may learn and use English rapidly, often resulting in a role reversal around age 12 in which children of recent immigrants develop better understanding of the majority culture. Such situations exacerbate the difficulties of parenting, significantly increasing the potential for maltreatment, particularly among adolescents.

Child abuse and neglect is supposed to be reported to Child Protective Services, but the system falls short of preventative measures to avoid reoccurrence, particularly with respect to Latino families. Without support and intervention by bilingual and bicultural staff, families are driven further inward and may become even more isolated as a result of unfamiliarity with the bureaucratic process and general fear of authority figures.

Our approach gave participants a range of wraparound services designed to support successful completion of substance abuse prevention and treatment programs by caregivers in order to remove substance abuse as a major contributor to child abuse in the family. All caregivers were either in the substance abuse treatment program when accepted into the empowerment project or were referred to the substance abuse treatment as part of the project assessment process.

 

OUTREACH

The empowerment project implemented a three-pronged outreach effort involving agency referral, public relations and street-based outreach to identify families potentially appropriate for the participation. Inter-agency and within-agency referrals were accepted. At the same time, project staff conducted outreach efforts among public agencies and community organizations involved in family support services and substance abuse prevention and treatment to alert them to the implementation of the empowerment project. The object was the establishment of an interagency collaboration, so that potential participating families are identified by public and private service providers for referral to the project. The referral process was facilitated through existing working relationships with some 70 public and private human service providers.

In addition to the involvement of the interagency network members, a variety of public relations techniques were utilized to get the word out about the project, such as press releases to local popular media and wide distribution of the bilingual, culturally appropriate project materials in the community.

Finally, "street-based" outreach was conducted in locations where potential participants are likely to be found, including churches, agricultural work facilities, Latino shopping districts, residential substance abuse facilities, detox centers, etc.

 

FAMILY ASSESSMENT

In order to assure that all prospective participants receive a comprehensive assessment of the family needs, when a family requests services or is referred to the project, an in-depth evaluation was performed following an initial intake process. The assessment was accomplished through interviews with most (if not all) members of the family in order to obtain needed information and ascertain the appropriateness of the project for the family (and vice versa). At the same time, all other materials were taken into consideration, such as reports and recommendations from the referring agencies, results of various evaluations and testing procedures.

Our assessment included the following elements for all family members:

a.) family social history, including child care and respite care needs and responsibilities,

b.) transportation resources and needs,

c.) housing situation, including possible overcrowding and potential for homelessness,

d.) substance abuse history on the part of the caregivers,

e.) domestic violence exposure,

f.) emotional and sexual abuse history

g.) educational level and intellectual functioning,

h.) work history,

i.) summary of reports and recommendations of referring agency,

j.) cultural and linguistic factors that are relevant to services,

k.) health assessment, as indicated,

l.) statement of outcomes the participants hope to achieve with timelines for attainment,

m.) recommendations regarding other support services that may be needed; e.g. job training, job placement, basic skills education, affordable housing.

Participant evaluation was accomplished through a conjoint process involving the project multidisciplinary team composed of child service professionals, substance abuse counselors, mental health professionals, social workers and participating family members. Every effort was made to fully involve participants in the assessment process to encourage their "ownership" and positive engagement in the project.

 

FAMILY SERVICE PLAN (FSP)

The results of the family assessment process were used by the project staff and associates to develop Family Services Plans (FSPs). The FSP was an action plan based upon the results of the assessment. It contains the steps needed to resolve problems that have placed the children in the family at risk of neglect and/or abuse. The strategies and activities, designed to help participants achieve each outcome, were specified, as was the service team member responsible for implementing the strategy or activity. The responsible person was a family member, volunteer (if appropriate) or one of the professionals involved in working with the family. In addition, the frequency, intensity, location, method of delivery, expected starting date and duration for each type of service was included. Outcomes were reviewed on a regular basis to ensure that progress had been made; whenever indicated, modifications in the FSP were provided. The FSP included the following elements:

a.) summary of reports and recommendations of the referring agency,

b.) cultural and linguistic factors that are relevant to services, including the primary language of the parents,

c.) health assessment, including a physical examination, vaccinations, nutrition factors, as indicated,

d.) significant prenatal and postnatal history of children,

e.) significant family social history,

f.) significant family needs; e.g. child care, respite care, transportation, translation, and referral information,

g.) results of testing and evaluation conducted during the assessment process,

h.) family input regarding concerns, priorities and resources related to reducing maltreatment risk factors for their children,

i.) statement of outcomes to be achieved during participation in the empowerment project along with timelines for progress milestones,

j.) action plan of project activities to be utilized during project participation,

k.) steps to be taken following graduation from the project to ensure successful transition to abuse- and neglect-free living situations.

 

WRAPAROUND SERVICES

Over the year, the management team at our agency observed that we served many members from the same family within different departments - different treatment programs. In order to acquire a higher quality of service - both efficacy and efficiency - we decided to introduce an empowerment project based on wraparound services offered internally and externally.

Internally, it was agreed that all agency departments will be offering services to the family members respecting the jointly defined scheme, that is, Family Service Plan (FSP); all participating professional staff and volunteers received additional training (between 20 and 40 hours). The following departments participated in the project:

1.) Outreach and Prevention,

2.) Substance Abuse and S.A. Prevention,

3.) Domestic Violence (Victims and Batterers Program),

4.) Mental Health for Children, Adolescents and Families, and the

5.) Adult Mental Health Department.

Externally, wraparound services were offered at several levels: "in-home," in-family services coordinated by the agency case manager and supported by the home visitor and tutor; additional services were provided by the extended family, direct neighbors and neighborhood volunteers:

1.) "neighborhood services" - services provided in the local community, focusing on the support and "friendly intervention" offered by the school teacher, local church clergy, staff and volunteers from the local community center and the like;

2.) "professional services network" - a formally defined network of the specialized social service agencies which operate in each of the two counties offering the following services:

a.) although most agencies were specialized either for a particular age, particular ethnic group and/or particular region, most offered comprehensive services through partial hospitalization, outpatient and outreach programs;

b.) most services were offered 24 hours, with specialized emergency services and crisis intervention;

c.) most agencies emphasized continuity of care, and

d.) prevention or preventive intervention.

Well-defined as "wraparound," the empowerment project was offered to 240 families in King and Pierce Counties during the predefined 18 months of the years 1994 and 1995.

 

FAMILY SUPPORT SERVICES

The empowerment project services process was initiated by developing a trusting relationship between the project staff and the family. This was initiated by the staff learning about the family's concerns and priorities for reducing and eliminating the factors that are placing their children at risk of maltreatment. Within the family parameters and the action plan contained in the FSP, participating family members would begin involvement in the project activities, focusing on family priorities and resources, the strengths and the needs of the at-risk children in the household and support needed to insure caregiver completion of substance abuse treatment.

The whole project was based on the concept of delivering in-home and neighborhood-based services to participating families to improve the parents' competencies in appropriate child rearing skills, while reducing the potential for their children being maltreated as a result of parental or caretaker substance abuse. A Case Manager was assigned to each participating family, who was responsible for ensuring that the family made progress toward achieving the outcomes in their FSP. The Case Manager had the duty to coordinate the work of a multidisciplinary team that included other professionals such as substance abuse counselors, mental health specialists, Home Visitors and volunteer "parenting role models" (whenever possible, close neighbors). The Case Manager placed an emphasis on ensuring that caregivers are receiving all required ancillary services to facilitate their attendance at, and successful completion of, substance abuse treatment programs.

Primary empowerment project service delivery methodology involved visits to the homes of the participating families by Case Managers, Home Visitors, and/or volunteers responsible for teaching parenting and lifestyle skills to the caregivers and at the same time monitoring the implementation of the FSP and providing direct support to caregivers in their daily living environment. The tutor was responsible for assistance to the children regarding their school related responsibilities and was an optional member of the standard "home team." Each family was entitled to the regular two-hour home visit based on individual family needs with no less than biweekly visits during service implementation. On average there were four visits per month during support service initiation, with the frequency escalating to as many as two times per week during family crisis situations. The Home Visitors worked closely with the parents to make sure that they have accessible support services, per steps contained in their FSP.

In addition to the support of the Home Visitors and Tutors, participating parents and children were involved in a variety of neighborhood-based activities including individual counseling, group counseling and culturally specific training programs designed to improve their competencies in life skills. All counseling services were provided by professionally trained and experienced agency staff. Individual counseling (1:1), on average, lasted an hour. Group sessions were performed in a group setting, with at most 15 group participants per counselor and they lasted an hour and a half on average.

Group sessions focused on such topics as anger management, conflict resolution, adult/child relationships and interpersonal skills development. Many family sessions were performed in the family homes, one counselor working with the whole family, an average counseling session lasting one hour. However, many counselors reported staying much longer (to express their respect for the culture).

With respect to parents, a peer support group was established as soon as possible (as an element of the future support center); group support was provided, as well as encouragement for the exploration of personal emotional development which would help them to better understand themselves and their children while significantly reducing and/or eliminating destructive and abusive behaviors toward their children. This group gave parents the opportunity to meet with their peers in a friendly, known, open, nurturing environment in which they were able to share their personal experience and explore the underlying reasons for placing their children at risk of maltreatment, while at the same time reinforcing techniques suggested by professional counselors regarding effective methods to reduce stress in the home and avoid situations that may lead to the abuse or neglect of their children. Three to five parents from each group were delegated to represent parents' needs and interests at the empowerment project level as members of the Parents Advisory Council (PAC).

Counseling activities for children focused helping children to overcome their traumatic experiences of being exposed to maltreatment in what should have been a comforting home environment. Age-appropriate therapy techniques were employed to engage the children in the counseling process; art and play therapy modalities were incorporated with verbal techniques and role playing. Individual therapeutic interventions focused on specific needs of each and every child; the number and length of these sessions also reflected the needs, severity of the trauma and progress. Different interventions were offered in a group format biweekly with a ratio of one staff person to 15-30 children, depending on the group activity; many sessions were devoted to training the children techniques to avoid abusive situations, as well as how to report maltreatment and seek help. Group sessions were conducted at different sites based on the children's area of residence; we tried to utilize convenient facilities throughout the target area such as schools, churches, community based organizations (while offering services, we were at the same time exploring the availability of the facility for the neighborhood support center).

Our target population has historically been difficult to reach with supportive services due to language barriers and cultural isolation from the larger community. The empowerment project provided the necessary support for the entire family unit through addressing and resolving the precursors to the abuse, thus eliminating the cause and changing the behavior. This was accomplished in a large part through in-home individual training activities, as well as group training offered in both formal workshop and informal group discussion settings. With appropriate coaching and tutoring monitored by staff, we anticipated that participating caregivers would demonstrate measurable improvement in their parenting and interpersonal general life skills.

We were completely open to the input from the parents regarding the topic areas for such training and our team predefined the following:

1.) basic parenting skills,

2.) conflict resolution,

3.) male-female relationships,

4.) anger management,

5.) appropriate interpersonal behaviors,

6.) effective stress management techniques,

7.) assuming personal responsibility for one's own actions,

8.) appropriate care giving techniques for at-risk children, and

9.) cultural heritage related to parenting.

For children, training focused on

1.) avoiding abusive situations,

2.) reporting maltreatment, and

3.) seeking help.

The objective of the training activities was to provide participating parents with enhanced abilities that will help prevent maltreatment before it occurs while empowering their children to take action should maltreatment occur. We offered participants a broad array of resources in order to help them eliminate or reduce the factors that may lead to abuse or neglect of the at-risk children in the home. Training was provided in a culturally-appropriate and gender-specific manner. To achieve this goal, our staff reviewed and adapted a large number of existing curricula such as Los Ninos Bien Educados, Para Los Ninos, El Milagro and many others.

In order to encourage participation we provided modest stipends for appropriate rewards and recreational activities; this included tickets to sporting events, field trips, and specific incentives received after completion of the FSP outcomes.

An additional intervention mechanism, a 24-hour "help line," was established as part of the empowerment project to provide participating parents with a professional emergency response to address parenting challenges or parenting crises. Participating caregivers, children (especially adolescents) and involved extended family members were enabled to reach project staff around the clock, as needed, through the help line. Qualified staff (Case Managers) was assigned to manage the calls on a weekly rotation basis, with a goal of returning all calls within 15-30 minutes. On-duty staff had to assess the situation and take necessary steps toward immediate conflict resolution.

One of the important tenets of our empowerment project was a tutoring program through which parents were provided with appropriate role models for successful parenting. Participants were selected for tutoring based on their needs, as indicated in their FSP.

Tutors were bilingual volunteers from the community; we tried to recruit them from the neighborhood. They provided participants with a positive, nurturing influence while demonstrating appropriate standards of conduct for effective parenting of at-risk children. For many participants, our tutors were the first positive parenting role models in their lives as the majority of them most likely have been themselves raised in abusive households in which substance abuse was considered "normal." The tutors worked individually with caregivers one on one in their homes to improve self-esteem and build ability to provide children with nurturing and loving care. All tutors completed 40 hours of training offered at our agency. We tried to maintain a pool of at least 20 volunteer tutors at any given time. Beside mentoring for the parents, tutors offered their services to the children, related to the family relations, school work and social skills.

In order to provide parents with the full support they need to overcome risk factors for maltreatment, participants in the empowerment project were offered respite care services so that they may be relieved of their parenting responsibilities for periods of time ranging from several hours to several days, depending on the individual requirements. Respite care was provided in convenient neighborhood settings utilizing available community (neighborhood) facilities. Respite care was offered so that parents have the freedom to attend the scheduled training and counseling activities, as well as simply to give them a "time out" from their day-to-day parenting challenges.

Participants were referred to different programs within the collaborating network to address additional supportive service needs, such as job training and placement, basic skills education, income support eligibility, immigration issues, cultural support groups and others. Project staff compiled and maintained a comprehensive directory of supportive services available in the community as an additional resource for the participating families. Recommendations for these referral resources were included in the FSP, and were modified as necessary, based on the family's progress as observed by the Case Manager, Home Visitor, and/or Tutor.

All services were provided utilizing a case management approach. Monthly case conferences were held by the multidisciplinary service delivery team to evaluate progress of the participants in improving parenting skills and reduction of actual and potential child abuse and neglect. Project staff prepared a detailed case management report on a quarterly basis; whenever feasible the report was shared with the extended agency team and the staff from the collaborating agencies. These reports formed the ground (basis) for the regular case conferences with the project participants. Recommendations for modifying the FSPs were made following consultation with the family members.

The focal point of the project was substance abuse treatment services: it was anticipated that the vast majority of caregiver participants will either be in a substance abuse treatment program when they are accepted into the project or will be referred for such services during the assessment process. Our agency was the only specialized provider of culture-specific services for Latino youth and adults in western Washington providing outpatient services, outreach, individual and group therapy and an Alcohol and Drug Information School. These resources were available to the project participants on an as-needed basis. The overall project approach was to facilitate the completion of substance abuse treatment by caregiver participants through the provision of the family support services described above.

 

FOLLOW-UP AND AFTERCARE

The basic FSP consisted of the two equally important components: six months of intensive service, with a six month follow-up and aftercare for all families that completed their FSP. Its primary purpose was to ensure that families are maintaining appropriate home environments. Following their participation in the project, staff served as a resource for parent "graduates" to help them in successfully maintaining their improved family living situation. Project staff was available to help family members troubleshoot problems and overcome any difficulties that may have arisen. Special emphasis was placed on verifying that the caretakers were maintaining sober living environments. Follow-up was accomplished using a variety of methods, including telephone contact and home visits, as well as contact with the children's teachers and staff from collaborating network agencies. The use of the Help Line was encouraged; calls from the program graduates were to be followed by a visit to the home. Program graduates were strongly encouraged to continue their participation in the peer support group or neighborhood support center. Also, they were encouraged to become volunteers after successfully completing their involvement in the project. As volunteers, these graduates assisted other parents learning to provide care to their at-risk children without exposing them to maltreatment.

We anticipated that by giving project graduates the opportunity to help their peers, we may reinforce the new parenting skills they just obtained through the Project, by helping at (through) the neighborhood support center to the new families and new project participants.

 

CONCLUDING REMARK

Through empowerment, individuals, families, communities and organizations can gain control and have a voice in decision-making about their well-being. Specifically, empowerment is a process through which people become strong enough to participate within, share control of and influence events and institutions that affect their lives (Torre, 1985).

As a result of the empowerment approach, family members begin to develop a less contaminated and constricted view of their situation and identity, and they take on a firmer appreciation of how their lives have been shackled by authorities, institutions and agencies. Thus, family members are helped in gaining a more authentic sense of who they are, what they do and what they want to do.

All families were helped; a very large number of our families, and in particular a large number of the younger members of the family, were empowered.

A. Both adults and children in the families:

1.) achieved understanding and knowledge about their own emotional development, as well as development of the interpersonal skills, anger management, stress reduction, and responsible behavior;

2.) were, all in all, helped legally, financially and educationally, and through a set of wraparound professional services, the family achieved better, healthier functioning;

3.) achieved insight in/about the problem and learned to seek appropriate help (this happened in about 30 percent of families with prolonged abusive behavior); for these families, it would be fair to say that they were helped on their way toward empowerment but that they still need more intensive, prolonged and individually tailored services.

B. Parents and other adults in the family:

1.) achieved improvement in their parenting, interpersonal and general life skills, and learned how to eliminate and/or substitute destructive behavior;

2.) resolved matters related to their immigration status with the help of specialized legal services;

3.) learned about their rights and the protection (often free of charge) which they can easily access;

4.) learned how to secure affordable (and sometimes free of charge) child care and respite care;

5.) acquired job training and knowledge on how to get a better and/or better paying job;

6.) connected with other families in the community and developed culture specific bondage, what represented the most empowering component of the overall project;

7.) achieved more appropriate knowledge about society at large and the ways to develop local, neighborhood connections.

C. Children and other young members of the family were:

1.) helped to overcome traumatic experience through age-appropriate counseling, therapy and other services;

2.) helped to understand their own parents (aunts, uncles) and serve as an additional source of their parents' (aunts/uncles) problem resolution and growth;

3.) empowered to prioritize their needs and need-related goals, focusing on their identity, education (school), free time and other activities;

4.) trained to avoid abusive situations, seek help (when help is needed) and report maltreatment in the case that it occurs again.

The empowerment project was a great learning experience for all of us. With great difficulties and many additional efforts, the basic project paradigm was implemented. We managed to offer an intensive six months of wraparound services in the home and in the local community to over 200 families residing in King and Pierce Counties in western Washington. We established three neighborhood support centers. We learned that such intensive services are helpful in preventing child neglect; families with already existing child abuse demonstrated a large number of long-lasting problems and such families needed differently designed approaches (long-term, individually tailored and specialized services).

The following experiences may be of help to other professionals who are contemplating a similar project:

1.) Many families needed over three months to develop open, trusting relationships with the three key members of the project team (Case Manager, Home Visitor and Tutor).

2.) Once such a relationship was established, family members demonstrated an "over- trust," or a need to constantly be in touch and consult team members regarding practically all family matters.

3.) Having that in mind it is easy to understand that the "completion" of services after six months comes as a shock to those families we served. Our team was the first "authority" they trusted; some kind of bond was created between them, their community (and culture) and mainstream society, and they feared that if they lost the established "bond" they would go back to where they were before entering the program.

4.) A similar situation was experienced regarding the "help line:" at first families experienced huge difficulties using the help line, even when the real crisis was taking place, but once they learned that it is very easy to "dial the number" they demonstrated a tendency to overuse the line, calling for all kinds of irrelevant, benign reasons.

5.) The situation was somewhat similar with children and youth: at first they feared that they may be punished by their caregivers (parents and/or other adults in the family) for "reporting" a potential maltreatment; often they called from the public phone, not from the family phone but once they learned that each call was handled with special care, they started to call on a regular basis (especially when the person on duty was a member of their family service team).

6.) We experienced a large number of problems regarding recruiting volunteer tutors and other volunteers; our families live in a neighborhood in which residents work long hours holding several (very low paying) jobs; many families have problems of their own as it was very hard to find positive role models and neighbors willing to offer four to six hours a week and after a while we had to lower our criteria and our demand regarding the culture (from being a member of the culture of the H/L community, we went to accepting as volunteers neighbors who have some knowledge of Spanish and the basic understanding of the Latino culture).

7.) We also experienced problems regarding development of the neighborhood support centers: to begin with, it was very hard to find a facility which was available in the neighborhood that was nice, safe, free of charge, open in the evenings and over the weekend; we tried to partner with the similar programs which already existed in the community; unfortunately we had to learn that there are many reasons (many constraints attached to the programs internally and/or externally, most often related to funding) why this is not possible.

8.) The same is true for the "help line;" we learned that it would be more expensive to partner with one of the existing help-lines than to establish our own "internal" help-line by using the agency's cellular phone.

9.) On the positive side, we learned that our best partners are graduates from the agency's substance abuse and domestic violence programs (former victims and abusers) as many of them expressed sincere interest in becoming a part of the project to achieve additional training (way beyond the required number of hours and predefined content); it seemed that at the same time they wanted to help members of their community and "pay back" to the agency but unfortunately the number of such families was not sufficient.

10.) Also, adolescents from such families were excellent volunteer tutors, but their number was way below our need; they did represent a great addition to the project, a facet which was not anticipated in the project paradigm: to deliver a clear positive message to the children and youth still living in neglecting and/or abusive families that the problems can be resolved, things can get better and that there are positive alternatives was one of the most powerful components of the program.

11.) An additional positive element, often "overlooked" by the professionals, was a rather strong bondage within the extended family: special caring attitudes, many positive elements which go beyond logic and comprehension (on one side we have neglect and/or abuse and, at the same time, on the other side we have love, respect, care and many other positive features).

We had to learn about many "ifs," most of which were related to the situation in the country of origin, family of origin and one's own childhood experiences and circumstances related to their immigration, as well as a rather complex, multifaceted matrix relating to "living in the U.S."

The etiology of child abuse is multiple, complex and interactional. Some authors argue that the forces are sociological. Polansky (1985) states that poverty and social change place considerable stress on families; when family has no one to turn to, all kinds of problems and/or crisis may result with which the family is not able to cope. There are contributing environmental conditions such as the lack of social services and other community-based services, unemployment and inflation, as well as highly bureaucratized, complicated procedures which often prevent families from seeking help.

The number of children and youth at risk who can benefit from preventive and support services is staggering. Evidence suggests that one-fourth of children in the U.S., by age 15, have a high probability of experiencing at least one risk tenet; another one-fourth are at moderate risk. The Urban Institute (1992) developed a model with points to the four components:

1.) previously existing problems such as poverty, neighborhood-environment-family dysfunction and other environmental forces can have negative effects on children and youth and make them increasingly vulnerable to later family, school or community problems;

2.) risk markers such as poor school performance or involvement with child protective services are visible indicators of problems linked with increased vulnerability and/or the potential onset of negative behavior;

3.) problem behaviors such as early sexual activity, truancy, running away from home, early use of tobacco, alcohol, or other drugs, as well as hanging around with gangs and delinquent peers have the potential to harm children and youth and community;

4.) risk outcomes such as pregnancy, homelessness, prostitution, delinquency, sexually transmitted diseases and other life-threatening conditions, as well as death by accident, suicide or homicid stem from problem behaviors; these outcomes are more prevalent than is generally assumed.

There is no doubt that societal and cultural factors, as well as the level of support available to families from the communities in which they reside have an impact on the nature and extent of problems experienced by families. No matter how troubled, all families have a certain amount of positive elements such as strength, which can be utilized while working with families. Effective prevention and intervention programs should capitalize on those elements.

 

BIBLIOGRAPHY

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GRAPH 1.

Breakdown by type of abuse

For 1993

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Breakdown of Fatalities
by abuse or neglect for 1993

Age of Child at Time of Death
For 1993

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GRAPH 2.

Race/Ethnicity of Victims

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EMPOWERMENT APPROACH TO THE PREVENTION OF THE CHILD NEGLECT AND/OR ABUSE

SUMMARY

This paper presents a brief description of the empowerment demonstration project. The goal of the project was to demonstrate an effective interagency collaborative approach for preventing and intervening in the maltreatment of children aged 0-18 living in families in which the caretaker is a substance abuser. A special emphasis was placed on working with families with adolescents. The primary target population was Latino families residing in the King and Pierce counties of western Washington in the U.S.

The overall objective of the project: to develop an innovative model of support for families in which there is a concurrent substance abuse and child neglect and/or abuse. Key components of the program are intensive, wraparound, in-home services delivered by the service team (Case Manager, Home Visitor, Tutor) according to the Family Service Plan (FSP), jointly developed by the agency team and family members. Our approach emphasized home visits by bilingual and bicultural professionals who will train participating family members in effective parenting techniques and monitor progress of the family members toward achieving goals stated in the FSPs. Additional project components include individual and group counseling, tutoring, diverse group training and a 24-hour help line. In addition, education was offered to the staff of the collaborating community agencies, family members and concerned people from the community regarding recognizing the precursor signs of concurrent child maltreatment and substance abuse. The objective of the empowerment project training was to provide participating caregivers with enhanced abilities that will help prevent maltreatment before it occurs, while empowering the children to take action should maltreatment occur. We aimed at giving participants a broad array of resources to help them eliminate or reduce the factors that may lead to neglect and/or abuse of at-risk children in the home. Overall, the service program was age-, gender-, and culture-specific. There were two six-month components of the program: the first six months focused on service delivery and the second six months presented a follow-up period primarily related to ongoing support for caregivers and other members of the family. All caregivers are encouraged and supported to complete a specifically designed substance abuse treatment program.

KEY WORDS: child neglect, child abuse, substance abuse, empowerment, collaboration, family-based wraparound services, Case Manager, Home Visitor, Ttutor, family service plan (FSP).