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Child Welfare

Critique of Self-Care Initiatives in the Helping Professions

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Generally speaking, helping organizations view humans from two polarized lenses.  Some organizations believe that their employees are good people and will always do their best despite any barriers that exist. Other organizations operate as if people are to be significantly controlled. These organizations believe without external control, people will give less than one hundred per cent and will somehow take advantage of benefits or in any way they can.

If you consume literature from publications like Forbes, Macleans (Canada), Time, or even through social media, you undoubtedly have read about efforts of progressive companies to foster production and actually take care of their employees in a holistic manner. We now know about the benefit to production, whatever the product may be, when organizations implement wellness strategies at work and give employees menus of wellness options to choose from which briefly take them away from production to have infusions of wellness.  In fact, this opinion is no longer just an opinion.  The evidence is clear. Organizations and societies who take care of their employees fair better on every indicator of production.

In the helping professions, our organizations are often well intended when they engage us in wellness conversations and efforts, but they often miss the mark. Helping organizations often bring in “experts” to talk to us at staff meetings. This act within itself is view as progressive and helpful. Again, while well intended, helping “experts” and their products miss the mark of what is needed to increase the wellness of helping professionals.  Why is this?

Strategies and self-care models offered to increase our wellness do not fit the nature of our work.  These models are based on static and linear models of work and production. For example, ten minutes of stretching likely benefits a professional helper who works a strict schedule and sees clients in an office for treatment blocks.  One can certainly take ten minute breaks and will reap the stress reducing benefits from those breaks.  Strictly office based helpers can often also find time to exercise at lunch, socialize in the lunch room, and so on, and therefore reap the resiliency benefits of these strategies.

The problem here is that the majority of helping professionals do not work in office based environments and see clients for therapy or for some other time specific service.  The majority of us work in child welfare, children’s or adult mental health, or crisis intervention environments.  Our “schedules” change several times a day as we meet the needs of our clients and respond to our communities’ crises.  A day in the life of a helping professional in these areas of practice looks more like a dog’s breakfast.  We don’t get set break times (they are there but we can’t and don’t take them because we are too busy), we don’t eat at set times and we almost always eat in our cars while travelling from situation to situation.

We forget to pee and poop.  No really we do.  We experience the sensation to pee, but it is often an hour or two or three before we actually remember or have the time to go. To be sure, it is just not possible to interrupt a suicide assessment, crisis phone call, apprehension with the police, or the like, to pee.  Not only do we care so deeply about our clients welfare that we wouldn’t interrupt our process with them to pee, but we also get used to ignoring our bodily indicators and in fact over time we actually divorce ourselves from a great deal of our biology.

This divorce from our biology often happens with ease because we are pumped full of stress hormones which naturally serve to put everything except the crisis at hand on hold.

While I don’t mean to belabour this point, it would be negligent not to note that if you follow the logic about the physiological and biological separations we perform in order to meet the needs of our client populations, you will understand that implementing any menu option from the typical self-care menu is literally impossible.  You can’t meditate on the witness stand, during an apprehension, or a suicide assessment.  You can’t break for a jog when you spend your lunch in your care driving and eating.

Following along with the logic of this work reality means that our self-care has to happen on our own time.  After work whenever that may be.  But if you’ve apprehended on this particular day, you are likely still at the office long after closing time.  You are settling the children at the foster home and then heading back to the office to prepare your court papers.  Your family, if you have one, doesn’t get to see mom or dad tonight because work responsibilities made that impossible.  The family may not get to see you tomorrow either because you may have to leave early for work in order to pick up your court papers and be able to serve them to your client family before court.

There eventually comes a day though when you things “slow down”.   A slowdown of course refers to the day when you get to try and fit in all of thing appointments and other tasks that you have had to put off due to the crises you have been responding to.  On these days you still eat in your care, don’t get breaks, but… you likely pee more regularly.

There seems to be a general understanding amongst us that if you are in this line of work for more than ten years you are a “lifer”.  I mean no disrespect to those that get out after a few years and in fact many of use envy you and are proud of you.  We still consider you one of us if you’ve been on the front line for even a few years before you leave because you “get it” and you are therefore one of us.

The life cycle of a lifer is as varied as is a day in our line of work.  Sadly though, many of us lifers don’t fare so well in our own personal lives.  There are many reasons for this but for me based on my dedication to understanding the harmful effects of trauma, it boils down to the cosmic roll of the dice of our stress hormones, traumatic exposure both direct and indirect, and to the overall impact of our divorce from our biology and often our bodies.  Many helping professionals  get sick from our work.  We all know colleagues who have chronic illnesses that really boil down to the harmful effects of stress.  The academic literature is now abundant in this area so you don’t need me to tell you about it.

The cost of our caring is too often too great.  I know we wouldn’t have it any other way but it is also not fair and just.  Given the strength of the literature in the area of trauma, burnout and compassion fatigue in the helping professions and the clear health consequences of chronic stress, I believe we can do much better in helping ourselves lead lives full of more wellness.  This requires a change in the structures of our work, it requires a change in organizational culture, and it requires a commitment of each one of us to be brave enough to talk about the cost of caring.

Next, we need to change organizations that view employees as ultimately malignant.  People don’t choose to be sick and they don’t want to be sick.   To be clear, psychological and emotional illness is a real risk in our work.  And, psychological and emotional illness can lead to a myriad of legitimate physical ailments ranging from the common cold due to compromised immune systems to auto immune illnesses like irritable bowel syndrome.

Organizations who view employees with suspicion are using faulty logic.  Not too long ago in my province we had a Premier who successfully waged a ware on welfare recipients by convincing the population that people on welfare are cheaters and have lazy characters. This of course is not true. People don’t choose to or want to be on Welfare.  Similarly, it is not flaws in our characters that make us ill.  We are not weak, and we do not need discipline to help us be more productive during times of illness.

What we need is wellness initiatives that fit with the nature of our work. These initiatives need to be dynamic and individualized.  I believe that we need individual wellness plans which are akin to Individualized Education Plans for children in our school systems with learning needs. We need modifications at times and accommodations that reflect the true nature of the stress in our jobs.

We cannot be expected to own our wellness when by its very nature our work often leaves us exhausted and without adequate time to rejuvenate. The ownership needs to be jointly held by us and our organizations, communities, and professional organizations.  We need nap pods, we need exercise equipment on site, and we need kindness which includes life affirming strategies aimed at reducing the host of risk factors are work puts us at risk of.

We also need parity with other helping professions and service providers such as first responders – Police, Fire, and Ambulance. I’m not sure how this has happened but we have lost a lot of ground in this regard.  In many provinces and jurisdictions, Police officers now make six figures and have the benefit of early retirement at full pension.  Most urban Police stations and fire halls have onsite gyms.  I do not begrudge this, in fact I applaud it.  But, we are also first responders and we are by and large not a healthy population by any indication.

Most importantly, we have to be clear about these truths. It is surely hard to admit that our work makes many of us ill in one way or another and by the very nature of our illnesses we want to avoid talking about them and truly addressing them.  We need to adopt real risk reducing strategies such as those employed by our Police partners. Can you imagine a Police officer attending a client home alone?  Working in partners is one of the most basic risk reducers available to us but we don’t have that option much of the time.

The evidence is not just anecdotal and therefore should not be dismissed. What needs to happen now is for us to bravely open up global conversations and create global movements to address our wellness.

Perhaps ironically, we are in fact a vulnerable population who are charged with serving, protecting and healing other vulnerable populations created by our society.  Society and systems create vulnerable populations, individuals do not create vulnerability in themselves.

Leaders who are responsible for the wealth of research pertaining to the cost of caring in our areas of work need to collect and collate information regarding the positive effects of workplace culture in addition to wellness options where organizations own the efforts and reap the benefits of those efforts. And, we need to strongly advocate for the end of career benefits that our Police, Fire, and Ambulance colleagues experience.

I believe we need an organization for social workers and helping professionals, a think tank of sorts,  whose purpose is to improve our lives at work and at home.  I’m sorry to have to say this but our professional organizations have missed the mark here.  More often than not, they exist to monitor and discipline us while protecting their interests. Who will protect and nurture our interests?

Clint has recently joined Social Work Helper as Digital Marketing Coordinator and Writer. He is a Canadian Social Worker who earned an Honors Bachelor of Social Work (BSW) from Laurentian University and a Masters of Social Work (MSW) from McGill University. Clint is in his 20th year of Social Work practice with interest and expertise in macro and systems level analysis and intervention, domestic family violence, trauma, stress, and post traumatic stress, child maltreatment, and solutions to reduce the impact of trauma in the helping professions.

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Child Welfare

To Counter Child Abuse, Administrators and Case Workers Need Support to Implement Evidence-Based Improvements

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In 2015, more than 425,000 children were placed in foster care due to incidents of abuse and neglect. But many unsubstantiated cases under investigation divert time and resources from handling cases that warrant close monitoring and attention. According to recent statistics, more than two million reports of child abuse and neglect were accepted for investigation in 2015 – with more than 700,000 of them eventually substantiated as cases of child abuse or neglect.

Imperfect Responses to Harmful Abuse and Neglect

Caseworkers often report that negotiating the multiple demands of their jobs puts them under constant stress. The sheer volume of Child Protective Services reports and investigations, the number of youth in foster care that need to be looked after, and the piles of paperwork that must be filled out to track decision-making – all of these burdens are overwhelming under the best of circumstances.

Faced with such workloads, agencies and caseworkers are ill-equipped to deliver services based on evidence of what works for youth and parents in the foster care system. The current standard of practice, however, leads agencies and caseworkers to engage in practices not supported by research-based evidence. Poorly conceived and delivered services cause considerable harm by failing to limit the incidence and after-effects of abuse and neglect.

Victims of child abuse and neglect are nine times more likely to become involved in crime and 25% more likely to experience teen pregnancy. Such victims also face increased risks of smoking, early-age drinking, suicidal ideation, inter-personal violence, and sexual risk-taking. The sad results become obvious in later years. Two-thirds of adults under treatment for drug abuse report that they were maltreated as children. And similar reports of childhood abuse come from 14% of men in prison along with 36% of incarcerated women. Four-fifths of 21-year-olds who were abused as children show evidence of at least one mental health disorder. And saddest of all, about 30% of child abuse victims will later abuse their own kids.

What Could be Done?

Several steps can be taken to improve responses to child abuse and neglect:

  • Improved, ongoing training and job support for caseworkers and supervisors could ensure that they know the characteristics of the populations they serve and are aware of effective anti-abuse practices and know how to deliver them or help clients find others in the community who can provide optimal help. Front-line workers also need training to monitor client progress and detect when a case warrants more intensive intervention.
  • Enhanced preventive efforts could save lives and money. Research shows that the total cost of new U.S. cases of fatal and nonfatal child maltreatment was approximately $124 billion in 2008. The estimated cost per victim of nonfatal child maltreatment was $210,012 in 2010, including the costs for health care, productivity losses, child welfare services, criminal justice procedures, and special education. In fatal cases, the figure rises to an astonishing $1,272, 900 per death.
  • Resources should be reallocated to areas of greatest need. In addition to redistributing available funding to hire more staff to manage high caseloads, innovative and effective programs and services must be delivered to prevent child maltreatment and fatalities. States should take advantage of funds offered by the federal government to expand evidence-based child welfare interventions that may have previously been underfunded.

Lessons from Philadelphia

A promising model comes from the state of Pennsylvania, which has participated in a federally funded project that allows child welfare agencies to use Title IV-E funds for evidence-based reforms. Philadelphia’s child welfare system has been at the forefront of adopting three evidence-based treatments for children and families that the city was previously unable to implement due to lack of funding. Waiver funds have made it possible to enhance preparation for child welfare caseworkers, develop databases to track outcomes for children and families, and train staff to identify and implement further improvements.

With flexible authority over spending, two child welfare agencies in Philadelphia decided to implement the Positive Parenting Program, an evidence-based approach to preventing child abuse. Although some reallocated resources have been used to train staff, additional funding is needed to discover barriers to effective program implementation and to implement additional steps known to be cost-effective – such as holding weekly consultations and boosting training for current and replacement leaders and caseworkers involved in the new program.

Research could pinpoint which approaches do best at giving various parents and youth access to the positive parenting program. And as parents and their offspring complete the program, further research would ideally track results in areas such as safety, reductions in abuse incidents, and improved parent-child relationships.

Next Steps

The Title IV-E Waiver Demonstration Project was a provision in the U.S. Child and Family Services Improvement and Innovation Act, which Congress reauthorized for five years in 2011. Now that the act is again up for reauthorization, Congress has the ability to implement changes to the way child welfare federal funds are allocated. Advocates for children have an opportunity to contact representatives and senators in Congress to propose that this program should expand to give more states the chance to reallocate funds and improve child safety.

Much remains to be learned about what it takes to carry out evidence-based interventions in the child welfare system, which provides vital help to many endangered children, youth, and families, disproportionately minorities. The federal Waiver Project provides a unique opportunity to observe what happens when system leaders, community partners, and providers mobilize to prevent childhood trauma. Lessons learned will help provide ongoing guidance to federal and state administrators and welfare leaders as they look for the most effective, empirically proven ways to protect children and families under their supervision.

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Child Welfare

Connected Commonwealth: Programs for Kentucky Youth Aging Out

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Photo Credit: Foster Youth In Action

In May 2016, Anna Shobe-Wallace, program manager for Louisville Metro Community Services said, “Each year, more than 500 young people between the ages of 18-21 age out of Kentucky’s foster care system.” Many youth ‘aging out’ are disconnected from larger society and face barriers to success such as: low socioeconomic status, low educational achievement, unplanned pregnancy, racial segregation, and mental and physical challenges.

A recent study assessed the plight of disconnected youth who are teenagers and young adults between the ages of 16 and 24, and these youths are neither employed, enrolled in or attending school. The study focused on disconnected youth in the following categories: by state, county, congressional district, gender, and by race and ethnicity. Currently, there is approximately 5,527,000 disconnected youth in the United States or 13.8% of young adults.

According to data from the study:

  • Kentucky ranks 36th in youth disconnection rates with 15.2% of youth in this group for a total of 81,850.
  • Cincinnati, OH–KY–IN ranks 44th in youth disconnection among the most densely inhabited areas. The percentage of disconnected youth in this area is 12.8% or 38,312 total. The racial breakdown for this group is 20.6% Black and 11.8% White.
  • Louisville/Jefferson County, KY–IN ranks 56th in youth disconnection. The percentage of disconnected youth in this area is 14.0% with a total of 21,750 disconnected youth. The racial breakdown for this group is 18.5% Black and 13.3% White. This Kentucky county has the lowest percentage of disconnected youth.
  • Kentucky counties with the largest percentage of disconnected youth are as follows: Martin County, Kentucky ranks 2,020th with 47.8% disconnected youth; Union County, Kentucky ranks 2012 with 43.7% disconnected youth; Bracken County, Kentucky ranks 1,998th with 41.4% disconnected youth; Lee County, Kentucky ranks 1,994th with 40.9% disconnected youth; McCreary County, Kentucky ranks 1,992nd with 40.4% disconnected youth; Morgan County, Kentucky ranks 1,985th with 38.7% disconnected youth; and Wolfe County, Kentucky ranks 1,972nd with 37.5% disconnected youth

Researchers from this study concluded that larger urban communities had increased numbers of disconnected youth due to the following indicators: a historical pattern of disconnection, decreased neighborhood well-being rates, low SES, increased unemployment, a lack of academic achievement, and racism.

These alarming statistics clearly indicated systemic issues that impact disconnected youth. Experts from this study proposed that, “Disconnection is not a spontaneously occurring phenomenon; it is an outcome year in the making.” With this thought in mind, the study recommended these steps moving forward:

  • An estimated $26.8 billion dollars was involved with supporting the nation’s 5.5 million disconnected youth— comprising Supplemental Security Income payments, Medicaid, public assistance, incarceration, in 2013. Proposing more beneficial ways to invest in this population would be advantageous to society as a whole.
  • Designing preventive measures to address disconnection by sustaining at-risk parents and investing in quality preschool programs. It is usually more cost effective and compassionate to implement prevention strategies than crisis responses.
  • Re-joining youth and young adults who are secluded from higher education and the job market is more expensive than pre-emptive methods that address disconnection at the outset. However, these young people need another opportunity—considering many came from challenging backgrounds.
  • At the community level, an evident positive correlation was seen between adult employment status and youth’s relationship to education and employment. The amount of education adults had greatly projected the likelihood of young people ages 16 to 24 years old to attend school.
  • Significant headway involves individuals and organizations cooperating to institute specific measurable attainable realistic timely (SMART) goals for decreasing youth disconnection.

Amy Swann, author of “Failure to Launch”, notes that for 2013, the study data indicates that the Louisville Metropolitan Area (which consists of bordering counties) has 14.0 percent of youth ages 16-24 disengaged from employment and education. The study’s emphasis on cities resulted in reporting by Louisville news outlets at the Courier-Journal and WFPL. Media exposure of the status of disconnected youth in Kentuckiana has led to remarkable new efforts that focus on this population.

In light of this compelling evidence: social workers, legislators, and other helping professionals in the state of Kentucky have amassed their efforts to cultivate community partnerships and programs to support disconnected youth on their journey into emerging adulthood.

According to their website, here is a description of each program, and how it addresses the needs of disconnected youth and youth ‘aging out’.

Family Scholar House plans to open its fifth Louisville campus at the Riverport Landings development in southwest Jefferson County. The project goal is to equip families and youth to excel in education and to obtain independence. The new facility is expected to be ready by 2017 and will accommodate low-income families, single-parent families, and young adults formerly in foster care.

Fostering Success is a summer employment program developed by Gov. Matt Bevin that began June 1, 2016. The program provides job training via the Kentucky Department for Community Based Services for youth ages 18 to 23 years old. The program will run for 10 weeks and culminate with meetings with college and career counselors to prepare participants for future education and employment goals. Approximately 100 youth will be employed full-time at a rate of $10.00 dollars per hour. Fostering Success is one of the seminal programs in the state to target youth aging out.

Project LIFE serves 60 kids across Kentucky, including 25 in Louisville and offers an empowering environment to prepare them for success. Youth are given a housing voucher, along with social supports to improve access to education, employment, and income management skills.

Coalition Supporting Young Adults (CYSA) is an initiative created to address the barriers faced by Louisville’s disconnected young people. The mission is to develop: a standard agenda that meets the needs of Louisville’s vulnerable youth and young adults; common measurement tools that define collective goals and strategies; mutually supportive activities that create new partnerships and execute thoughtful programs; effective communication that creates a viable structure; foundational support that stimulates growth, responsibility, and dependability.

Transition Age Youth Launching Realized Dreams (TAYLRD) is an effort to create a unique program for young people born out of the federal government’s proposal called “Now is the Time” Healthy Transitions Grant Program. The Department of Behavioral Health (DBH) in Kentucky requested and received funding and Seven Counties was chosen as a venue to open drop-in centers where young people can foster relationships and access support /services to achieve their future goals. Youth Peer Support Specialists (YPSS) and Youth Coordinators work together with clients to define what concerns are most important, and then appropriate services/supports are brought into the drop-in centers. Some of the supports/services offered include: case management, life skills development, employment services, academic support, legal support, and therapy.

True Up founded by foster care alum Frank Harshaw, is a nurturing group of foster care alumni who have overcome obstacles to employment, pursuing education, gaining independence and solidifying healthy relationships. They have chosen to pay it forward through mentorship. True Up empowers foster youth through academic and hands-on learning in the following areas: Mobility & Transportation, Career Mapping, Financial Management, Relationship Building Skills, and Educational Achievement.

These are just a few of the innovative programs and resources available in the state of Kentucky. As helping professionals and the broader community create data driven programs for disconnected youth and youth aging out, expected outcomes will be much more positive in the near future.

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Child Welfare

Rep. Bass Introduces The Foster Youth Mentoring Act

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On June 23, 2017, Rep. Karen Bass (D-Calif.) introduced legislation to authorize funding to support mentoring programs that have a proven track record in serving foster youth. Rep. Bass serves as a Co-chair of the Congressional Caucus on Foster Youth, which is a bipartisan group of lawmakers dedicated to improving the country’s child welfare system.

“It is critical that we raise awareness about the unique challenges young people in the system face,” Bass said. “In all of my years working in child welfare, meeting thousands of children either in or out of care, we’ve heard their voices clearly: They want a consistent source of advice and support–someone that will be there when it matters most and for all the moments in between. Many people think of mentors as something supplementary. But for these kids, sometimes it’s all they have. I’ve introduced this piece of legislation to not only showcase the importance of modernizing the child welfare system but also to raise awareness about this important national issue. There are kids in every congressional district that would benefit from this bill’s passage.”

“Youth in foster care face enough challenges. Having a consistent caring adult in their lives shouldn’t be one of them,” said MENTOR: The National Mentoring Partnership’s CEO David Shapiro. “Mentors offer much-needed stability and support academic achievement, professional and social-emotional development, and provide the kind of individual attention often not possible through the child welfare system.

The Foster Youth Mentoring Act would expand urgently needed access to this critical asset for so many more young people in need. Closing this support and opportunity gap for youth in foster care through evidence-based relationships can help reverse the negative outcomes we see far too frequently for these young people compared to their peers. MENTOR thanks Representative Bass for her tremendous leadership in working to improve outcomes for these young people and elevating the personal stories of foster youth to a national level through her work in Congress.”

Read their joint op-ed in the Huffington Post about the importance of mentorship here.

Bill Summary

The bill connects youth in foster care with adult volunteer mentors by providing support for mentoring programs for foster youth. The bill would:

  • Authorize funding to provide support to mentoring programs that serve foster youth. Programs would be eligible to receive funds to support the expansion of their services to more youth in foster care and to improve services for current foster youth in their programs.
  • Ensures that mentoring programs participating in the grant program are currently engaged or developing quality mentoring standards to ensure best practices in the screening of volunteers, matching process and successful mentoring relationships.
  • Provide intensive training to adult volunteers who serve as mentors to foster youth to assure that they are competent in understanding child development, family dynamics, the child welfare system and other relevant systems that affect foster youth.
  • Increase coordination between mentoring programs and statewide child welfare systems by supporting the expansion of mentoring services for foster youth.

The Foster Youth Mentoring Act seeks to address the need for greater support of mentoring programs that serve youth in foster care.  Foster youth face challenges as they navigate growing up often without the support of a consistent caring adult. The Foster Youth Mentoring Act seeks to fill that gap to provide foster youth with the social capital, resources, and support they need to develop positive relationships and connections.

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