The good practice guide to Child Aware Approaches: Keeping children safe and well

CFCA Paper No. 21 – May 2014

A. Child Aware Approaches are family-sensitive

Family-sensitive approaches recognise the centrality and importance of family life for most people.4 They take into consideration the familial and broader social context of the client and understand that a client's "parenting role may be both a motivator for change as well as a potential stressor" (Australian Centre for Child Protection, 2012). Family-sensitive approaches support clients in their parental role, as well as taking into consideration the needs of their children, in order to improve treatment outcomes and maintain the safety and wellbeing of the clients' children (Trifonoff, Duraisingam, Roache, & Pidd, 2010). Being family-sensitive involves focusing on the strengths and assets of families and "view[ing] families as resources and partners in the client-worker relationship" (Trifonoff et al., 2010, p. ix). Family-sensitive approaches are therefore based upon open communication and respect for families and an understanding of families' needs and preferences.

In terms of being Child Aware, family-sensitive approaches require taking into account a client's role as a parent and how their presenting issues (e.g., drug and alcohol misuse, mental health) may influence this. It also involves a consideration of the practical requirements of parenting (e.g., planning meetings around child care availability) and an understanding of how other family members or the broader family context may support the client in their parenting and in addressing their concerns.

Principle 1: Identify and respond to the needs of adults who are parents

Practice considerations

  • Are parenting strengths and coping strategies identified and supported? Do your information-gathering processes include consideration of family and relationship strengths and resources?
  • Do you have ways of identifying how parents' problems may be affecting their parenting capacity and parent-child relationships?
  • Does your client have unresolved trauma that may be affecting their parenting capacity?
  • Have you considered the ways in which the needs of fathers may be different to those of mothers?
  • Does strengthening parent-child relationships form part of your client's treatment goal?

Principle 2: Acknowledge and build on family strengths while responding to family stressors and risk factors for child abuse and neglect

Practice considerations

  • Do your organisation's intake and assessment procedures identify whether the client has a parenting or caregiving role? Is the broader family situation and the wellbeing of children explored?
  • Are other relevant family members (e.g., partners, parents, children, siblings) offered age-appropriate information about: the services their relative is receiving and their opportunities to be involved in care; the condition affecting their relative; and support services available for them as family members?
  • Does your organisation train staff in appropriate ways of identifying potential family or domestic violence?
  • Are procedures in place if serious family safety concerns are identified?

Further resources

  • Children of Parents with a Mental Illness (COPMI) offers two free online courses:
  • The National Centre for Education and Training on Addiction (NCETA) has produced a range of documents and resources for practitioners working in the Alcohol and Other Drug (AOD) workforce:
  • The Bouverie Centre has produced a range of resources on family-sensitive practice for the mental health services
    • a concise overview of what they consider to be the seven principles of Family Sensitive Practice as well as a brief explanation of the underlying assumptions of family sensitive practice: <www.bouverie.org.au/programs/mental-health-team/family-sensitive-practive-family-sensitive-training/assumptions-family>;
    • Guidelines for Trauma-Informed Family Sensitive Practice in Adult Health Services, which has been designed to assist adult health services and practitioners in adopting a family sensitive and trauma-informed approach to their work: <www.childaware.org.au/images/the_bouverie_centre_la_trobe_university-web.pdf>; and
    • family-sensitive training designed to assist mental health services and practitioners work more respectfully and inclusively with families: <www.bouverie.org.au/taxonomy/term/51>.

Child Aware Approaches in action ...

Substance misuse and family violence
Organisation National Centre for Education and Training on Addiction (NCETA), Flinders University
Resource Can I Ask ...? An Alcohol and Drug Clinician's Guide to Addressing Family and Domestic Violence
What is it?

NCETA produced a comprehensive, evidence-informed guide for AOD practitioners that introduces the research on the intersection between AOD, family and domestic violence (FDV) and child protection, and includes strategies for identifying and responding to FDV when working with potential victims or perpetrators. The resource offers practical tips and common traps for discussing FDV with clients. Appendices and further resources are provided and include items such as a safety checklist for those experiencing violence, information on indicators of intimate partner violence, and an interagency referral form.

The resource is supported by a literature review entitled, Breaking the Silence: Addressing Family and Domestic Violence Problems in Alcohol and Other Drug Treatment in Australia (Nicholas, White, Roche, Gruenert & Lee, 2012).

How is the resource child-aware? Can I Ask ...? brings together knowledge from two areas that are known risk factors for child abuse and neglect: parental substance misuse, and family and domestic violence. It provides information for practitioners aimed at raising awareness and understanding of how FDV may be affecting clients and their children. The resource is child-inclusive and offers a section specifically on talking to parents about their children. The document provides information on the importance of collaboration between organisations (a key principle of Child Aware Approaches) and when it is appropriate to do so. The resource provides practical information on how AOD practitioners can be more child-aware in their practice.
Practice inspiration

Among the practical resources included in the guide, NCETA provide examples of some questions that may be incorporated into initial client essions in order to identify potential FDV. Some of these are listed below:

Where there are indications that further questioning may identify FDV, the following questions may be used: a

  • Has your current (or recent partner) ever:
    1. done things that raised safety concerns for yourself or your children?
    2. threatened to harm you or your children?
    3. insulted, screamed or cursed at you?
    4. physically hurt you, your children, or your pets?
  • Do you feel unsafe in your current relationship?
  • Are you afraid of your partner?
  • Are you afraid of anyone close to you?
  • Have you ever been emotionally or physically abused by your partner or someone close to you? For example, is your partner excessively jealous, possessive and controlling, or hostile towards other men whom he sees as a threat?
  • Is there a person from a previous relationship who makes you feel unsafe now?
  • Has your partner ever forced you into sexual activity against your will?
  • Do you feel unable to interact with friends, family or your community?

a Yes answers indicate likelihood of abuse (White et al., 2013, p. 7)

Who is it for? AOD practitioners; also relevant to FDV and child protection workers
Further information

Can I Ask ...? can be ordered free of charge from: <nceta.flinders.edu.au/nceta/publications-and-presentations/order-publications> or download Can I Ask ...? (PDF 1.3 MB). at: <nceta.flinders.edu.au/files/2713/6615/8232/EN488_2013_White.pdf>.

Breaking the Silence (PDF 2.2 MB) can be downloaded at: <nceta.flinders.edu.au/files/6513/5285/7437/EN469_Nicholas_2012.pdf>.

Education in prisons
Organisation Extra Edge Community Services Inc.
Program Child Aware Prisons Program (CAPP)
What is it? The program involved workshops for prison officers and incarcerated mothers (Haslam, 2013). The workshops provided information on child development, attachment, early brain development and the effects of trauma on both the parent and child. The program also explored the effects of domestic violence, poor mental health and alcohol and drug use on child development. Other agencies were involved in delivering aspects of the program, with the aim of engaging prisoners with services they could contact upon release.
How is the program child-aware? The program was family-sensitive as it looked beyond the women as prisoners to see them in their roles as mothers. The program focused on the effects of parental risk factors on child development. Finally, the program targeted adult service providers and prison officers, and worked to raise their awareness of the issues affecting the prisoners and their children.
Who is it for? Prison officers and incarcerated mothers
Practice inspiration

For practitioners, an important finding of the program report was that the environment matters. Pre-conceived attitudes and beliefs along with the physical environment can have a real effect on the efficacy of programs.

A report on CAPP highlighted the effect that the prison environment (the physical environment plus the attitudes and beliefs of the prison officers) could have on both mothers and children. The prison environment may be particularly confronting for children. The report highlighted the effect that prison officers' assumptions and pre-conceived ideas were seen to have on the interactions between mothers and children. When the officers had negative opinions about the suitability of children in the prison setting and/or beliefs that the mothers did not, in general, care about their children, this could negatively affect mothers' interactions with their children and influence other prison officers' attitudes and behaviour. A friendly and attractive environment could help alleviate negative interactions between mothers and their children. Creating a physical environment that included things such as suitable floor coverings and age-appropriate toys helped make visiting sessions easier for all involved.

Further information Information on the CAPP program can be found at: <eecs.org.au/programs/child-aware-prison-program/>.
Family-sensitive research data preparation
Organisation Marymead Centre for Early Life Matters
What did they do? Marymead collected and coded data and built a dataset that enabled post-intervention change to be recorded and measured for an early intervention/prevention treatment program (Marymead Centre for Early Life Matters, 2013). This allowed Marymead to do a preliminary data analysis of change after clients participated in the Circle of Security early intervention/prevention program. The project coordinator was subsequently able to commence a more detailed analysis of the prepared dataset and write-up of findings as part of a three-year PhD project through Macquarie University (2013-16). In addition, staff at Marymead, researchers and students were trained in the Circle of Security program, while a small number of staff and researchers were provided with Advanced Sensitivities Training.
What is it? A research-ready dataset to enable evaluation of the effectiveness of the Circle of Security early intervention/prevention approach to working with parent-child dyads. The Circle of Security program is designed for infants/young children showing a number of risk factors for poor mental health and developmental outcomes. This program has not previously been evaluated in this depth in an Australian community context.
How is the resource child-aware? The coding of assessments and preparation of the dataset of pre- and post-intervention assessment scores will allow research to be undertaken to measure post-intervention change and analyse the effectiveness of the program. The Circle of Security intervention was family-sensitive as it worked with caregivers to reduce perceived child behavioural and emotional problems by mitigating against poor developmental outcomes and reducing the risk of future abuse and neglect. Circle of Security was also child-focused as it aimed to reduce parenting difficulties and associated stress, reduce child emotional and behavioural problems and/or parents' perceptions that these were problems, improve parental empathy for the child, improve parental capacity to better understand and respond to the child's needs, and improve parental capacity to better understand and regulate their own emotional state and behaviour in their relationship with their child.
Who is it for? The resulting research dataset is enabling a PhD project to evaluate the effectiveness of the Circle of Security early intervention/prevention treatment program. The dataset was also used by practice staff, clinicians, practitioners and researchers as a way of identifying post-intervention change, and a preliminary determination of effectiveness of the intervention with clients of the program. Through the data collection, research and training at Marymead, collaborative relationships with two universities and opportunities for student placements were developed to enhance future research and evaluation in clinical practice.
Practice inspiration The unique opportunity to train Marymead staff in research techniques allowed staff to develop a greater understanding of how research and evaluation contribute to the evidence base, and how this evidence could be directly applied in a therapeutic setting. Staff gained important understandings regarding the requirements of collecting data that adheres to protocols; for example, the effects of missing and/or erroneous data on data analysis. By collecting and preparing an accurate research-ready dataset reflecting the reality of family circumstances, and enabling change to be subsequently evaluated, this project increases the likelihood that family-sensitive therapeutic intervention approaches (i.e., appropriate and effective for families with complex backgrounds) will be chosen.
Further information Further information about the Circle of Security research dataset and the PhD project that followed has been presented at some conferences, but is not publicly available. However, information on the Marymead Centre for Early Life Matters can be found at: <www.marymead.org.au/programs/counselling-support/early-life-matters>.

 

Footnote

4 "Family" is a complex and diverse construct and may have different meanings for different people. In the context of this paper, family is considered to be self-defined and, as suggested by Lodge, Moloney & Robinson (2011, as cited in Moloney, Weston, Qu & Hayes, 2012), is "most commonly thought of in terms of a sense of belonging - usually, though not always, linked by biological and/or marital relationships" (p. 1). (For a discussion of several of the ways in which "family" can be defined, see Lindsay & Dempsey, 2009.)