Families with multiple and complex needs

The latest material added to the Australian Institute of Family Studies library database is displayed, up to a maximum of 30 items. Where available online, a link to the document is provided. Many items can be borrowed from the Institute's library via the Interlibrary loan system.

See more resources on Families with multiple and complex needs in the AIFS library catalogue

Supporting staff to work with children and families with complex needs: a checklist for organisations

Price-Robertson R, Meddick T and Parker E
Hilton, S. Aust. : Emerging Minds, 2019.
Written for managers, practice leaders, and other decision-makers, this paper provides with practical guidance on supporting staff to work with children and families with complex needs. It is aimed at a broad range of health and welfare organisations, particularly those not specifically designed to work with clients with multiple interrelated problems. The paper reviews the critical domains in organisations that facilitate the recruitment, development and ongoing support of staff who are confident and skilful at working with children and families with complex needs.

National evaluation of the Troubled Families Programme 2015 to 2020: findings : evaluation overview policy report

Great Britain. Ministry of Housing, Communities and Local Government
London : Ministry of Housing, Communities and Local Government, 2019.
The British Government's 'Troubled Families Programme' aims to transform the lives of families with multiple and complex problems, including worklessness, poor school attendance, mental and physical health problems, crime and anti-social behaviour, domestic violence and abuse, and children in need of help and protection. The first version of the programme ran between 2012 and 2015 and informed the development of the programme that is now in operation. This new version will be evaluated from 2015 to 2020, measuring outcomes over a five year period in terms of improving outcomes for families, transforming local services, and providing savings for the taxpayer. This suite of documents presents the fourth update on the evaluation. This overview report summarises the findings to date, with more detail published separately on the staff surveys, family surveys, and case studies. Overall, the findings suggest that the programme is making a significant impact on some of the key outcomes measures and with a good rate of return on investment.

Supporting children in families with complex needs: nine tips for practitioners who feel out of their depth

Price-Robertson R and Schuurman C
Hilton, S. Aust. : Emerging Minds, 2019.
Many families who access health and welfare services present with multiple interrelated problems, so it is common for practitioners to feel overwhelmed by the complexity of the needs of such families, especially when children's welfare is at stake. This paper provides guidance and encouragement for practitioners who are feeling overwhelmed or out of their depth. It outlines ways to begin to develop confidence when working with specialist and complex needs and lists resources for further reading.

Services to young people with complex support needs in rural and regional Australia : beyond a metro-centric response.

Ellem K, Baidawi S, Dowse L and Smith L
Children and Youth Services Review v. 99 Apr 2019: 97-106
This article explores issues in providing services to young people with complex support needs in rural and regional areas, drawing on interviews with service providers in Queensland, New South Wales, and Victoria. Though the participants reported similar challenges to those facing workers in urban areas, these challenges were exacerbated by the local factors facing smaller and geographically dispersed communities, such as vast distances and worker recruitment. The article discusses the impacts on engaging and serving young people and the implications for policy and practice.

Breaking down the barriers: findings of the National Commission on Domestic and Sexual Violence and Multiple Disadvantage.

National Commission on Domestic and Sexual Violence and Multiple Disadvantage (London, England), Agenda (Charity), Against Violence & Abuse (Organization)
London : Agenda and AVA, 2019.
The National Commission on Domestic and Sexual Violence and Multiple Disadvantage was established by British charities AVA and Agenda to investigate the situation of women who have experienced violence and go on to face a range of other issues including addiction and poor mental health. This report presents the Commission's findings and recommendations. The report provides insights into the challenges facing these women in England and Wales, and looks at: the links between domestic and sexual abuse and multiple disadvantage - particularly mental health, substance use issues, homelessness, and poverty - across women of different identities, in particular race, ethnicity and disability; the experiences of women facing these issues, including their views on what services would best meet their needs and support them to rebuild their lives; current provision to support these women, including gaps and current shortcomings in the system; and evidence, ideas and good practice around how best to support these women. The Commission drew together a panel of leading experts, a Community of Practice of professionals, public submissions, and volunteer peer researchers. Eleven main themes emerged from the data collected; poverty, accessibility, homelessness, the criminal justice system, multiple disadvantage and trauma, trauma-informed response, partnership, parenting, gender-sensitive service provision, funding and commissioning, and early intervention. This final report includes a copy of the report by the peer researchers 'Hand in hand: survivors of multiple disadvantage discuss service & support'.

Hand in hand: survivors of multiple disadvantage discuss service & support

Hailes A
London : Agenda and AVA, 2018.
A National Commission on Domestic and Sexual Violence and Multiple Disadvantage has been established by British charities AVA and Agenda to investigate the situation of women who have experienced violence and go on to face a range of other issues including addiction and poor mental health. As part of this work, volunteer peer researchers were recruited and trained to conduct interviews with other women in their communities to ensure that the voices of those with lived experience were included. This report presents the findings and analysis of these interviews with 29 women from England and Wales, highlighting the far-reaching impacts of abuse and trauma. Topics discussed include types and experiences of abuse, 'honour' based violence and abuse, impacts of abuse, identifying abuse, help-seeking, police, health services, mental health services, substance use services, specialist domestic abuse services, housing and homelessness, and issues relating to children.

Evidence brief: complex needs

Chen E and Hanks M
Wellington N.Z. : Oranga Tamariki Ministry for Children, 2018.
This paper provides a high-level overview on the nature and service responses regarding complex needs among children and young people involved in the care and youth justice systems. It summarises the latest international literature on the definition and frameworks of complex needs in care populations, the characteristics of those with complex needs in the care and youth justice populations, risk and protective factors, and service and therapeutic responses. Children in the care and youth justice populations experience multiple issues - from behaviour problems to drug abuse - that are interrelated and serious, but the evidence base for what works in addressing such complex needs in care is relatively limited. Males, and those identifying as indigenous, are over-represented in the care and justice systems of many jurisdictions, and deprivation, poverty, and a history of trauma are particular risk factors.

Improving lives - helping workless families: indicators 2018

Great Britain. Dept. for Work and Pensions
London : Dept. for Work and Pensions, 2018.
In 'Improving lives - helping workless families', the British Government sets out proposals to improve outcomes for children who grow up in workless families. The policy was supported by a strong evidence base, published in an 'analysis and research pack' featuring the latest research and a set of nine indicators to track progress in tackling disadvantage. This new 2018 report updates the indicators with the latest data. The indicators cover the prevalence of parental conflict, entrenched worklessness, poor parental mental health, family breakdown, homelessness, problem debt, drug and alcohol dependency, children's educational attainment, and youth participation in education, employment, or training.

Service provision framework: Multiple and Complex Needs Initiative

Victoria. Dept. of Health and Human Services
Melbourne : Victorian Government, 2017.
This document provides practice guidelines for the coordination and implementation of the MACNI program in Victoria. The Multiple and Complex Needs Initiative (MACNI) is a time-limited, voluntary, specialist service for people 16 years and older in Victoria, who have been identified as having multiple and complex needs. This includes people with combinations of mental illness, substance abuse issues, intellectual impairment, acquired brain injury, forensic issues, and these people often pose a risk to themselves or to the community. MACNI is a shared service across the Department of Health and Human Services and the Department of Justice and Regulation. This document outlines the service model, including operational processes and decision-making points.

Improving lives - helping workless families: analysis and research pack

Great Britain. Dept. for Work and Pensions
London : Dept. for Work and Pensions, 2017.
In 'Improving lives - helping workless families', the British Government sets out proposals to improve outcomes for children who grow up in workless families. This document presents the strong evidence base that underpins that policy paper. It combines the latest research with new insights from survey and administrative data, and was created by leading academics, analysts, and policy-makers across government as well as local authorities and front-line workers. Part one focuses on children in workless families, setting out the evidence behind some of the issues associated with persistent worklessness, how these disadvantages are often connected with other factors, and how they impact on children's outcomes. Part two presents nine national indicators, with supporting measures, to track progress in tackling the disadvantages that affect families and children's outcomes. These include the prevalence of parental conflict, entrenched worklessness, poor parental mental health, family breakdown, homelessness, problem debt, drug and alcohol dependency, children's educational attainment, and youth participation in education, employment, or training.

Improving lives: helping workless families

Great Britain. Dept. for Work and Pensions
London : Dept. for Work and Pensions, 2017.
In this publication, the British Government sets out proposals to improve outcomes for children who grow up in workless families and face multiple disadvantages. It draws on new analysis on the stark difference in outcomes between children in workless families and those in lower-income working families, with workless families considerably more likely to experience problems with their relationships, have poor mental health, and be in problem debt. This Government will help these families by expanding the Troubled Families Programme, launching new local-level interventions to reduce parental conflict, and targeting at risk parents with complex issues or substance dependency through the welfare system. The first section sets out the case for change, based on the evidence on parental worklessness. The next section explains the steps for action, before concluding with a section on how progress will be monitored.

Patterns of multiple disadvantage across New Zealand families

SuPERU (New Zealand)
Wellington N.Z. : Social Policy Evaluation and Research Unit, 2017.
The Social Policy Evaluation and Research Unit is investigating the issue of multiple disadvantage in New Zealand, which has been difficult to define and quantify. This project aims to develop a measure of multiple disadvantage and use it to understand the prevalence of multiple disadvantage across New Zealand families, the types and combinations of disadvantage most commonly experienced, and the disadvantages with the greatest impact on family wellbeing. This paper presents the first findings from the project. After considering what multiple disadvantage is and the value of measuring it, it provides initial data on the number of disadvantages that New Zealand families face, whether some family types face more than others, the proportion of all disadvantage borne by those experiencing multiple disadvantage, the most common types of disadvantage, and whether some disadvantages types occur mostly on their own or with many others. Data is taken from the 2014 General Social Survey. The next stage of the project is then discussed.

Cradle to Kinder: evaluation summary

Victoria. Dept. of Health and Human Services, Australian Institute of Family Studies, Royal Children's Hospital (Melbourne, Vic.). Centre for Community Child Health
Melbourne : Dept. of Health and Human Services, 2017.
The Cradle to Kinder program is an intensive ante- and post-natal support service in Victoria that provides longer term intensive family and early parenting support for vulnerable young mothers and their families, commencing in pregnancy and continuing until the child reaches four years of age. The Victorian Department of Health and Human Services contracted the Australian Institute of Family Studies in partnership with the Centre for Community Child Health to undertake an evaluation of this program, and it was undertaken between February 2013 and September 2015. The Department is now releasing a summary of the evaluation report to the public. The summary describes the client characteristics, summarises qualitative and quantitative findings on its impact on parents and children, and highlights the key enablers, challenges, and opportunities for improvement. The Aboriginal Cradle to Kinder program is also discussed. Overall, data from the first two years of operation suggests that the design, implementation and delivery of the Cradle to Kinder program has been successful and that the program has largely met its objectives and has been an important addition to the suite of services available to vulnerable families in Victoria.

The Justice Project: people who experience family violence : consultation paper

Law Council of Australia
Braddon, A.C.T. : Law Council of Australia, 2017.
The Justice Project is the Law Council of Australia's national review into the state of access to justice in Australia, focusing on the barriers facing those with significant social and economic disadvantage. A series of papers will explore the issues facing specific groups in more detail, with a review of the literature on what is known about each group's legal needs, how they respond to legal problems, the barriers that constrain each group from accessing justice, the legal capabilities of individuals within each group, critical gaps in services which deliver access to justice, laws and policies which exacerbate barriers to justice, the costs and consequences for not accessing justice, and what services and policies are working well and why. This paper focuses on people who have experienced family violence. Family violence intersects with a number of legal areas including divorce, parenting matters, criminal justice, victims of crime assistance, and child protection, and victims of family violence are often dealing with other forms of disadvantage- adding to the complexity of their legal needs.

Stronger safer together: a reflective practice resource and toolkit for services providing intensive and targeted support for Aboriginal and Torres Strait Islander families

Secretariat of National Aboriginal and Islander Child Care
Hawthorn, Vic. : Australian Policy Online, 2016
This resource aims to support good practice learning and reflection for workers providing intensive or targeted family support services to Aboriginal and Torres Strait Islander families with multiple and complex needs. Sections include: Working differently with Aboriginal and Torres Strait Islander families; Building trusting relationships and partnerships with families; Identifying the needs of children and their families; Providing an appropriate mix of practical, therapeutic, educational and advocacy supports; Including families in case planning and decision making; Working effectively with statutory child protection agencies; and Ensuring worker safety, self care, boundaries and supervision. There is also an appendix on using child and family assessment tools.

Overcoming Indigenous disadvantage: key indicators 2016 : report

Australia. Steering Committee for the Review of Government Service Provision, Australia. Productivity Commission
Melbourne, Vic. : Productivity Commission, 2016.
This biannual series provides a public account of progress in addressing Indigenous disadvantage in Australia. It reports against the six targets set by the Council of Australian Governments in 2009 - life expectancy; young child mortality; early childhood education; reading, writing and numeracy; Year 12 attainment; and employment - as well as other key indicators and priority established since 2003. The report also identifies the sources of wellbeing and the factors behind policies and programs that have been successful in addressing Indigenous disadvantage. This report presents the findings for 2016. Overview and fact sheet versions are also available.

National evaluation of the Troubled Families Programme: final synthesis report

Day L
London : Dept. for Communities and Local Government, 2016.
The British Government's 'Troubled Families Programme' - launched in 2011 - aims to transform the lives of families with multiple and complex problems. An independent evaluation of Phase One of the Programme commenced in 2013 and culminated in a set of final reports in September 2015. This document summarises the evaluation's findings, and is complemented with a series of technical reports providing further details of the impact analysis of the administrative data, survey data, process evaluation, and qualitative research with families. Overall, the evaluation sought to understand: how the Programme has made a difference to the lives of families, both in terms of outcomes and experience of services; the impact on local delivery approaches; the impact on planned outcomes; and monetary savings.

Strong Start - Northern Pilot: evaluation report

Harman-Smith Y, Wilson A and Brinkman S
Adelaide, S. Aust. : Public Service Association of SA, 2015.
Strong Start is a pilot home-based program in Adelaide, South Australia, that aims to improve the health and wellbeing of families and children at risk of adverse outcomes. It targets first time mothers who are experiencing multiple and complex issues, to help them prepare for the arrival of their infant, develop skills to cope with challenges, connect them to resources, and increase their parenting capacity. The program was initially implemented in the northern metropolitan area and was later expanded to the south. This evaluation focuses on the northern pilot, and examines program delivery and recruitment and early outcomes for mothers and infants. It draws on interviews with program staff and clients as well as an audit of administrative data. This report presents the findings of the evaluation and highlights key areas for improved service provision.

Service coordination in communities with high social needs

Taylor B
Sydney, N.S.W. : Standing Committee on Social Issues, 2015.
The 2015 Dropping off the Edge report highlighted that communities with high social needs face disadvantages that are entrenched, persistent and complex. However, such disadvantage necessitates a collaborative policy and service approach to ensure sustainable and positive change - no one agency is able to address the range of complex and interconnected needs involved. This inquiry was commissioned to investigate service coordination in communities with high social needs in New South Wales. Issues include the extent to which government and non-government service providers are identifying the needs of clients and providing a coordinated response, barriers to the effective coordination of services, information sharing and data collection, privacy law, competitive tendering and funding models, initiatives such as the Dubbo Minister's Action Group, and best practice models for the coordination of services. This report presents the findings and recommendations of the inquiry.

Working with families who experience parental mental health and/or drug and alcohol problems in the context of child protection concerns : recommendations for service improvement.

Coates D and Howe D
Australian and New Zealand Journal of Family Therapy v. 36 no. 3 Sep 2015: 325-341
Implementing sustainable interventions aimed at improving parental mental health or drug and alcohol problems can be challenging for families with multiple risk factors. This article reviews a trial of a new service model, investigating the strengths and limitations of the model through interviews with clinical staff and former clients. The clinicians highlighted difficulties working with this complex client group and its impact on staff burnout, and former clients highlighted the importance of the relationship with the worker in establishing client engagement and facilitating change. The implications for service design are discussed.

Review of the evidence for intensive family service models

Macvean M, Sartore G, Mildon R, Shlonsky A, Majika C, Albers B, Falkiner J, Pourliakas A and Devine B
Ashfield, N.S.W. : NSW Family & Community Services, 2015.
This report identifies interventions that have been found to be effective for improving outcomes in families with a range of vulnerabilities, such as low income, child abuse or risk of child abuse, family violence, or parental or child mental illness or substance misuse. The review identified 45 interventions, which were typically multicomponent and centred on families with complex needs including a history or risk of maltreatment. This report was commissioned to help inform service reforms at the New South Wales Department of Family and Children's Services, and the considerations for implementing such interventions in this local context are also discussed. The main report is accompanied by three appendices - 2 documents providing additional detail on the methodology used and interventions found and a spreadsheet matrix of intervention delivery methods and content.

Rapid evidence assessment of case management with vulnerable families

Sartore G, Harris J, Macvean M, Albers B and Mildon R
Ashfield, N.S.W. : NSW Family & Community Services, 2015.
This report evaluates the use of case management with vulnerable families or families with complex needs. It reviews Australian and international evaluation studies of different case management models, focusing on the structures of collaboration, coordination and communication involved in the case management process, rather than on the underlying clinical practices, services or programs delivered to families. Case management is an intervention intended to assist individuals and families with a wide range of challenges in accessing needed services, and is also known as care coordination and case coordination. The review finds that currently there is insufficient evidence to determine if case management is effective for improving child, parent or family outcomes, and there is a need to build this evidence base.

The evaluation of the 'Protecting and Nurturing Children - Building Capacity, Building Bridges' Initiative

Gibson C, Francis H, McDougall S, Arney F, Grauwelman-Smith R and Parkinson S
Underdale, S.A. : Australian Centre for Child Protection, University of South Australia, 2015
The 'Protecting and Nurturing Children: Building Capacity Building Bridges (BCBB)' was a national workforce development initiative funded by the Australian Government under the National Framework for Protecting Australia's Children. It was undertaken by the Australian Centre for Child Protection in partnership with twelve Communities for Children programs sites, and involved over 2000 practitioners from more than 250 organisations. The initiative aimed to transform the goals of the National Framework into action that made an impact within communities - through building practitioner capacity and strengthening collaboration between adult-focused and child and family focused services. In short, adult problems are the cause of more children entering the child protection system, and a different approach - combining support and collaboration - is desperately needed. This report outlines the formative evaluation of the initiative and its key learnings.

Families with complex needs: international approaches

SuPERU (New Zealand)
Wellington N.Z. : Superu, 2015.
Some families have on-going multiple and long-term needs that require many sources of support. This paper provides an overview of approaches from Australia, the United Kingdom, and Canada to support these families. It considers issues in understanding and defining families with complex needs, and reviews the literature on effective policy initiatives, programmes, strategies and legislative approaches. The implications for service development and delivery in New Zealand are also briefly discussed.

The Troubled Families Programme: the perfect social policy?

Crossley S
London : Centre for Crime and Justice Studies, 2015.
"No social policy can expect to achieve a 100 per cent success rate and yet, according to government, the Troubled Families Programme has achieved almost exactly that. The programme has apparently turned around the lives of some of the most disadvantaged and excluded families in a remarkably short period of time. All of this has occurred against a backdrop of cuts to local services and welfare reforms which have hit, not just families, but also the organisations and councils that deliver services to them. This briefing paper traces the history of the programme and questions claims of success made by government and their problematic use of data. Quite simply, the reported successes of the Troubled Families Programme are too good to be true and require closer public and political scrutiny than they have received to date."

The benefits of the Troubled Families Programme to the taxpayer

Great Britain. Dept. for Communities and Local Government
London : Dept. for Communities and Local Government, 2015.
The British Government's 'Troubled Families Programme' - launched in 2011 - aims to transform the lives of families with multiple and complex problems. However, this programme benefits not only the individual families but the wider community. This paper highlights the benefits of the programme to the public purse so far, with examples of savings that have been made and costs that have been avoided for many parts of public services in seven sites in England. It describes government spending on troubled families before and after the programme was implemented, and the impact on such services as criminal justice, domestic violence, health, education, and children's services. The methodology of this analysis is published separately.

Stories of impact: the 'Protecting and Nurturing Children - Building Capacity Building Bridges' (BCBB) Initiative

Australian Centre for Child Protection
Underdale, S.A. : Australian Centre for Child Protection, University of South Australia, 2015
The 'Protecting and Nurturing Children: Building Capacity Building Bridges (BCBB)' was developed and delivered by the Australian Centre for Child Protection as a key initiative supporting the 'National Framework for Protecting Australia's Children 2009-2020'. The overall goal of BCBB was to take a national policy and connect it to specific community visions. Working with both child and family focused and adult focused services, it aims to enhance the knowledge and skills of practitioners to support parents and improve the way that families with multiple needs experience the service system. This paper describes the initiative and its work as well as some of the learnings from its 12 community sites.

Towards program evaluation for practitioner learning : human service practitioners' perceptions of evaluation.

Herbert J
Australian Social Work v. 68 no. 4 2015: 438-452
While human service practice improvement is acknowledged as an important outcome of program evaluation, much evaluation is narrowly focused on accountability requirements. This type of evaluation often has limited use and relevance to human service practitioners. In exploring forms of evaluation that do have practice relevance, this article presents the experiences and perceptions of human service practitioners subject to evaluations that set out to foster learning. Across the cases participants expressed concerns about data quality and credibility, the relevance of evaluation data to the program context, the invasiveness of the evaluation, management of the process (particularly limited consultation with practitioners), and the lack of effective dissemination. These cases illustrate the challenges for evaluation to be useful to practice, and to foster meaningful improvements to services. (Journal article)

Summary report of the request for Information: How can government improve results for our most vulnerable ( at-risk) children and their families.

The Treasury, 2015
The New Zealand Treasury put out a request for information on what the government could do to make the biggest difference in assisting hard to reach families. They especially wanted to hear from people who work with vulnerable families. They received over 250 submissions which discussed how services can better meed people's needs; what already works well; how services can work together; what gaps exist in service delivery; and what are the challenges faced by those who deliver services.

Integrating social services for vulnerable groups : bridging sectors for better service delivery

Organisation for Economic Co-operation and Development
Paris : OECD Publishing, 2015.
This book explores how services can be best integrated to help vulnerable groups. It discusses challenges involved, identifies good practice, and describes and assesses integrated services approaches in OECD countries for 3 vulnerable groups: the frail elderly, the homeless, and children and young people with mental health concerns. Other topics include the benefits of helping vulnerable groups, opportunities and barriers for service integration, and definitions and prevalence of family vulnerability.
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