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Human Services

Is Counseling For You

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Have you been in counseling or therapy? If not, have you ever hesitated in seeing a counselor, or wondered why you felt so wary? Studies show about 20-35% of Americans having attended some form of counseling and psychotherapy compared to approximately 80% of mental health professionals.

Believing that counseling and psychotherapy could be helpful for anyone in alleviating problems, improving relationships, and developing a more positive outlook toward life, a Journal for Human Services research study explores why some people attend counseling or therapy while others do not.

Researchers, Ed Neukrug, Mike Kalkbrenner, and Sandy Griffith wondered why it was that some people seemed readily to attend counseling while others hesitate or who don’t attend often to their own detriment. Their research on attendance in counseling of helping professionals and their upcoming research on attendance in counseling of the public in general offers a thoughtful analysis which will hopefully shed some light on this important concern.

After an exhaustive review of the literature, researchers independently looked at over 60 potential barriers to attendance in counseling and eventually reduced this number down to 32 specific items. Their research found three broad areas or reasons likely to affect individuals who tend to avoid counseling and therapy. They identified these areas as “Fit,” “Stigma,” and “Value” to reflect the areas they represent.

Factor 1: Fit

Fit has to do with one’s sense of comfort with being in counseling and whether one has the ability to trust the process of counseling will be beneficial. Some typical fit questions were related to whether a potential client believed a counselor would feel comfortable with the potential client’s sexuality, disability, or other aspects of the client’s identity. Other questions in this area assessed whether a potential client believed a counselor could understand him or her, was competent enough to deal with the client’s problem and could keep the client’s concerns confidential. In addition, other “fit” questions queried whether potential clients had a bad experience with a counselor in the past and if they thought they could find a counselor near to where they lived

Factor 2: Stigma

Stigma is the feeling of shame or embarrassment some people experience when they consider entering a counseling relationship. Some of the stigma questions highlighted whether a potential client believed their friends, family, peers, colleagues, or supervisors might view them negatively if they knew the individual was in counseling. Other questions focused on how some potential clients might consider themselves weak, embarrassed, or unstable if they were in counseling. Often, those with high scores on stigma believed others would judge them, and thus, they would feel badly if they were to enter counseling.

Factor 3: Value

Value is the perceived benefit or worth one believes he or she is receiving from attendance in counseling. Potential clients who would score high in this area often believed the financial cost of counseling was not worth its benefits. Participants in this category simply could not afford counseling or they didn’t have time for it. Many participants in this category believed counseling wasn’t necessary because problems usually resolve on their own, or that counseling was simply not an effective use of their time. These individuals simply did not embrace the counseling process because the financial costs in their mind are hard to justify over meeting basic needs and/or having to take time off from work.

Although some individuals cannot find a counselor to their liking, participants worried whether counseling would be worthwhile, or they were ashamed or embarrassed about going to counseling. Most people believe that when faced with difficult life problems, counseling could be helpful.

It is hoped through research like this, people can better understand why they might be hesitant to seek a counselor and  maybe overcome some of their fears. Additionally, this research can help national organizations, in the helping fields, find ways to help clients overcome these barriers.

Edward Neukrug is a Professor of Counseling and Human Services at Old Dominion University. In addition to teaching, Dr. Neukrug has worked as a counselor at a crisis center, an outpatient therapist at a mental health center, an associate school psychologist, a school counselor, and as a private practice psychologist and licensed professional counselor.

          
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Child Welfare

Right from the Start: Investing in Parents and Babies – Alan Sinclair

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It is widely accepted the earliest months and years of a child’s existence have the most profound impact on the rest of the lives. Attachment theorists believe the early bonds and relationships a child forms with his/her carer(s) or parent(s), informs that child’s ability or inability to form successful and healthy relationships in the future.

Alan Sinclair’s ‘Right from the Start’ is the latest in the Postcards from Scotland series of short books, which aim to stimulate new and fresh thinking about why us Scots are the way we are.

In my previous book review in the Scottish Journal of Residential Child Care, I commended the author of ‘Hiding in Plain Sight’ (another book in the same series) Carol Craig for her ability to write succinctly and accessibly about a complex subject matter. I feel the same way about Alan Sinclair’s writing in this book.

The premise of this book, put simply, is laying out the bare truths of how good and bad us Scots are at parenting as well as having the appropriate supporting systems in place for parents and carers of our most vulnerable children.

A consistent thread throughout the book is the author arguing that by investing in parents and babies ‘from the start’, governments and the surrounding systems who support children and families can relieve the heartache of tomorrow in the form of poorer outcomes in education, employment and in health.
The book begins by acknowledging the UK’s position on the UNICEF global league table of child well-being, ranking 29 of the world’s richest countries against each other. The UK is placed 16th, our particular challenge being a high proportion of young people not in work, training or education. Although the league table did not single out the devolved nation of Scotland, the author describes the UK as a ‘decent proxy for Scotland’.

The first 1,000 days

The author goes on to explore the theory of the first 1,000 days of a child’s life. This theory suggests this is the most significant indicator of what the future holds for them. He touches on child poverty, which we know from well-cited research can lead to adversities in life, but he also mentions too much money can be an issue as well.

This point is explored more deeply later in the book’s in a chapter titled: ‘Is social class a factor?’. The author is effective at challenging the popular rhetoric that it’s the least educated and most poverty-stricken parents in society who are most likely to neglect their children. He talks about the longitudinal study, Growing Up in Scotland, which tracks the lives of thousands of children and families from birth to teens. Amongst many other findings, the survey shows 20% of children from the top income bracket have below average vocabulary; it also finds problem-solving capabilities are below average for 29% of this group. This proposes child poverty is only a small indicator of the child’s developmental prospects.

Where the Dutch Get it Right

The most intriguing part of the book from my point of view is the comparison the author makes between raising a child in Scotland versus the Netherlands (which ranked first in the UNICEF league table). In Holland, pregnant women have visits from a Kraamzorg, an omnipresent healthcare professional who identifies the type of support required. Post-birth the Kraamzorg plays a very active role and can typically spend up to eight hours a day supporting the new mother in her first week of childcare. The Kraamzorg also becomes involved in household chores including shopping and cooking. And it doesn’t stop there. The Dutch system includes Mother and Baby Wellbeing Clinics, which support families from birth to school age and have been doing so effectively for the last century.

On reading how the Dutch system operates, it’s hard to not make comparisons to the system here in Scotland (and the wider UK) within our NHS where mothers are wheeled in to give birth and very quickly wheeled out again to free up bed space. I exaggerate slightly here and I do not want to discredit the incredible job hard-working NHS staff do, but I’m sure I’m not alone in feeling envious of the Dutch system and thinking they’ve got something right, in comparison with Scotland. This was neatly summarised at the start of the book in a quote from a Dutch woman who had spent time living in both Holland and Scotland when she said: ‘In Holland we love children. In Scotland you tolerate children.’

But it’s not all bad. As the author remarks himself: ‘Scottish parenting is not universally awful: if we were we would not be almost halfway up the global table of child well-being’ (p. 12).

The penultimate chapter explores some real-life examples of parents who are struggling and striving to succeed in bringing up children with some success despite the odds stacked against them. I found the author’s injection of such human stories among the explanation of evidence useful as it allowed a chance for the reader to reflect on how all this is applicable in everyday life in Scotland.

To me, there was, however, a glaring omission in these stories: a voice from the LGBT community. Gay adoption in Scotland was legalised almost 10 years ago in 2009, and at the same time the Looked After Children (Scotland) Regulation 2009 came into force allowing same-sex couples to be considered as foster parents. It would have been interesting to hear from this historically marginalised part of our society what the experience has been like and how different, or similar, this was from the other stories included in this chapter. Are they arguably better equipped as carers of Scotland’s most vulnerable children given their own life experiences of being marginalised?

The book ends with the author setting out his vision for a better future for Scotland’s children where they have better life chances and are fully nurtured. It’s clear we have some way to go but reading this book makes you feel a glimmer of hope that could, one day, become a reality.

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Child Welfare

Reps. Bass, Marino Introduce Legislation To Develop And Enhance Kinship Navigator Programs

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Earlier this week, Rep. Karen Bass (D-Calif.) and Congressman Tom Marino (R-Penn.), Co-chairs of the Congressional Caucus on Foster Youth, introduced legislation to provide grants to states, tribes (including tribal consortia), territories or community-based organizations to develop, enhance, and evaluate Kinship Navigator programs. Kinship Navigator programs support family caregivers through complex legal and administrative systems, help avert crises, prevent multiple child placements, and avoid the need for more costly services.

“With the rise of substance abuse highlighted by the opioid epidemic, more and more kinship caregivers are stepping up to raise children in need of temporary care or permanent homes,” said Rep. Bass. “This is happening in every state and every county in the United States. While we work to address this immediate epidemic, our child welfare systems are being overwhelmed. Kinship caregivers need support and this bill will help provide the assistance necessary to creating a stable home and environment for the child. I hope Congress can come together on this bipartisan issue to stand up for our kinship caregivers and our nation’s most vulnerable youth.”

“Every child deserves to grow up in a healthy, safe, and loving home,” said Congressman Marino. “We know that when children grow up in stable households, they are much more likely to succeed as adults. This legislation will help ensure that every foster child has the opportunity to pursue their dreams, start great careers, and raise loving families of their own.”

The bill will allow community-based organizations to apply directly to the Department of Health and Human Services for funding and also require program evaluations that include community perspectives. You can read the full bill here.

Why Kinship Care Matters:

Research demonstrates that children in kinship care are less likely to experience numerous different placements with different families. Kinship care results in better outcomes for all children living in out-of-home care because they are more likely to remain in their same neighborhood, in the same educational setting, be placed with siblings, and have consistent contact with their birth parents than other children in foster care. This is one critical piece in improving outcomes for the children in the child welfare system.

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Child Welfare

What is Collaborative Law and Social Work

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Collaborative Family Law offers divorcing couples a new approach to untangling marriage. The traditional approach has family lawyers settle disputes with at least the threat of litigation.

Collaborative Family Law takes the threat of litigation out of the equation to concentrate on helping the parties settle between themselves yet with legal support. Litigation is not an option.

Lawyers practicing Collaborative Family Law report more satisfaction with this form of practice and believe that negotiated settlements leave the parties more intact as individuals and as parents.

Along with the new approach to settling disputes, there is a new role for those professionals who would otherwise practice divorce mediation or provide custody and access assessments.

These professionals, often social workers and psychologists, are being reenlisted by Collaborative Lawyers as Divorce Coaches and Child Specialists.

In traditional family law, a Divorce Coach may be hired to prepare one parent for court in order to gain a strategic advantage in the litigation process. In the Collaborative Law context, the Divorce Coach helps the parent to understand emotional issues that could cause him or her to be unreasonable.

In other words, in the former context, the coach helps make a better warrior for the battle of litigation, while in the latter context the coach helps make a better conciliator to facilitate settlement. Within the Collaborative Law model, each parent has his or her own Divorce Coach.

The “Child Specialist” is generally described in therapeutic terms, working with the children directly. In this context, the Child Specialist meets with the children to help them deal with the impact of the parents’ divorce on their lives. The Child Specialist may also share information with parents to help them protect the children from untoward outcomes.

There can be challenges arising when using individual Divorce Coaches and Child Specialists as described. Each coach may provide perspectives or information to their respective client that pulls them in different directions, confounding settlement. Certainly “over-identification” with one’s client is a risk inherent in any form of individual support.

Further, when a Child Specialist meets alone with children, there can be conflicts of interest and confidentiality issues if the Child Specialist then reports to parents. Some jurisdictions have confidentiality rules for counsellors working with children, particularly early adolescents.

There are ways to mitigate these issues.  Social workers have a rich tradition in working with entire family. As such, the social worker can engage the entire family in a consultant role. Within this role, perhaps titled Family Divorce Consultant, one social worker would be assigned rather than hiring two separate coaches.

Working from a system’s theory perspective and using clinical discretion, the social worker would have latitude to meet with the entire family system and/or pertinent subsystems (marital, sibling, parent-child and even individuals) as necessary.

The Family Divorce Consultant’s involvement would be time limited and goal directed. The goal is to facilitate the transition to a new family structure (pre-divorce to post divorce) whilst maintaining the integrity of pertinent relationships. Further, the consultant would provide education to the parents to facilitate their mutual interest – the well-being of their children now and developmentally.

Social Work has much to offer Collaborative Family Law. Social Work is built on a tradition of inter-disciplinary teamwork with the goal of win/win outcomes. The structural changes sought to facilitate post-divorce adjustment meet well with the training and values of social workers. Collaborative lawyers and social workers make a natural team.

Collaborative lawyers looking for social workers should consider those with; a “systems” perspective; custody and access experience; current knowledge of relevant theory and practice of divorce and child development; and good inter-personal boundaries. Collaborative Law marks a revolution in thinking. Next will be interesting to view the evolution. Social work is a good fit.

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Child Welfare

Why Involving Entire Families in Child Protection Cases Can Improve the Lives of Endangered Children

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By: Susan Meyers Chandler and Laurie Arial Tochiki

Annually, about 435,000 children across the United States are taken away from their custodial parents following a confirmed incident of abuse or neglect. In 2015, approximately two million cases of abuse and neglect were accepted for investigation by child protection services agencies in the fifty U.S. states. Although other family members currently care for such children in informal arrangements, the vast majority of children in protective cases are placed with non-biological foster families (now called resource families) until the parent’s home is considered safe.

Outcomes in the child welfare system are relatively poor – with such children at high-risk for school dropout, homelessness, unplanned and unwanted pregnancies, and future joblessness. According to available research, kinship and foster placements protect children and eventually reunite them with their biological parents about equally, yet kin placements are less disruptive. In practice, however, many child protective services agencies do not encourage kin to get involved in decisions until after a case of abuse or neglect has been confirmed.

Challenges in the Child Welfare System

Children and families who enter the child welfare system often have multiple challenges including behavioral health issues, special educational needs, substance abuse challenges, and delinquency. Often the families are poor, struggle with food and housing insecurity, and may have poor parenting skills or mental health challenges.

Various public agencies are charged with meeting these multiple needs, but child protective services agencies, by legal mandate, are the sole state system charged with ensuring children’s safety and well-being – and these agencies are bound by firm administrative rules and practices that often exclude family members and other relatives from involvement in decisions about the child. Due to confidentiality requirements, other child-serving agencies may not be involved, either. Nevertheless, research shows that children needing protection do better when their families are involved; and collaboration among various service agencies also improves outcomes for children and their families.

What Can Be Done?

Although family inclusion does not consistently happen, it is stressed by most child protective services agencies and a cornerstone of federal and state policy. The federal Fostering Connections Act of 2008 now requires that, within 30 days, child protective services notify adult relatives and grandparents that a child has been removed from parental custody. Family members are required by law to be included in case planning and decision-making meetings. In addition, financial assistance for guardianships is now provided when children are placed with relatives.

The 2010 Child Abuse Prevention and Treatment Act Reauthorization requires agencies to document their capacity to ensure meaningful involvement of family members in the planning, implementation, and evaluation of child protective decisions. For all states, a Child and Family Services Review evaluates conformance with federal requirements. This review measures family engagement and agency practices that reach out to extended family members. Restorative practices are encouraged – such as agency efforts to promote healing in family relationships and involvement in family conferences. Newer models of family engagement include creating family “circles” that acknowledge the harm done, further child safety and parental confidence, and provide ongoing family support services.

Lessons from Innovations in Hawai’i

The state of Hawai‘i has a state-wide system of family conferencing that is offered to all families entering the child welfare system. Family Group Decision Making is based on an indigenous process developed in New Zealand. In Hawaiʻi, the ʻOhana Conferencing model draws upon western mediation and social work practice, as well as the indigenous Hawaiian practice of reconciliation and forgiveness. The system has involved more than 17,000 families in the decisions involving children in the child welfare system, by assuring that families are:

  • Included in the decision-making process as true, respected and active partners in the decisions that affect them;
  • Listened to and heard, with their input valued;
  • Encouraged to find appropriate strategies to solve their own problems;
  • Actively engaged in collaborative problem-solving;
  • Equipped with the knowledge that there are partners in the community to help support the child and the family;

Using ʻOhana Conferencing has allowed Hawaiʻi to enjoy one of the highest percentages of kinship care in the child welfare system. The state is in the top three for kinship care, and more than two-fifths of children in protective care have been placed with kin since 2008.

ʻOhana Conferencing is strengthened by Hawaii’s strong process for strong commitment to finding kin and including all appropriate family members in the decisions about protection and foster care placements. This Family Finding process has reduced the number of children living in foster care and improved outcomes for the state’s endangered children.

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Child Welfare

100 Former Foster Youth Visit Members of Congress to Advocate for Child Welfare Reform

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Before the foster youth shadows met their Members of Congress, they gathered as a group for training with the FosterClub. Photo Credit: Congressional Foster Youth Caucus

Each May, the Congressional Caucus on Foster Youth introduces a resolution to recognize May as National Foster Care Month. Last year the resolution was cosponsored by more than 130 Members of Congress. In addition to re-introducing this important resolution to call attention and raise awareness about this issue, the Congressional Caucus on Foster Youth will be hosting a range of events in May, including a panel on May 23rd to discuss kinship placement and navigator programs which will also be streamed on Facebook Live.

The National Foster Youth Institute (NFYI, www.nfyi.org) is gearing up once again to bring over 100 current and former foster youth, selected from a nationwide pool of applicants to Washington D.C. for a week of leadership training sessions, workshops on activism, and legislative meetings, culminating in an opportunity to spend a day “shadowing” their individual Congress members. Shadow Day attendees, some as young as 18, have all spent time in the foster care system and will share their experiences, while advocating for reforms in the child welfare system, both in their district and nationwide.

NFYI creates the Shadow Day Program each year, in partnership with the Congressional Caucus on Foster Youth, providing a forum for members of Congress to discuss and develop policy recommendations which strengthen the child welfare system and improve the overall well-being of youth and families. Co-chaired by Rep. Karen Bass (D-CA), Rep. Tom Marino (R-PA), Rep. Brenda Lawrence (D-MI), Rep. Diane Black (R-TN), and Rep. Jim Langevin (D-RI), the bipartisan Congressional Caucus on Foster Youth brings together over 100 Members of Congress to discuss the challenges facing all foster youth and develop bipartisan policy initiatives.

NFYI’s Shadow Day Program has trained a corps of foster youth alumni across the nation who have developed chapters in their home districts and partnered with local leaders and organizations to educate policymakers to addresses chronic problems within the national, state, and local child welfare systems.

Rep. Karen Bass (D-CA, 37th), during Shadow Day 2017, stated that government essentially becomes “the parents” when it puts children in foster care, and then “washes our hands of them” once they turn 18.

“Any time a foster youth falls through the cracks, then the government is really responsible because when we remove children from their parents, we — meaning the government — become the parents, we are responsible for them,” Bass said on the House floor. “So, we’re working on legislation to improve that.”

No one knows more about the pitfalls of our nation’s child welfare system than those who grew up in it. These young people are coming to D.C. to share their stories both – their challenges with abuse, trafficking, overmedication, or homelessness – and their successes with mentorship, adoption, family reunification, community activism and independent living. The goal is to help Congress understand how to improve the child welfare system.

“National Foster Care Month is a month to honor the successes and challenges of the more than 400,000 foster youth across the country and to acknowledge the tireless efforts of those who work to improve outcomes for children in the child welfare system. Making sure that all children have a permanent and loving home is not a Democrat or Republican issue—it should be an American priority. This May, we come together to celebrate the experiences of the youth who are in, or have been in, the child welfare system and raise awareness about their needs.” – Bipartisan Congressional Caucus on Foster Youth

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Child Welfare

Exposure to Domestic Violence Costs U.S. Government $55 Billion Each Year

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The federal government spends an estimated $55 billion annually on dealing with the effects of childhood exposure to domestic violence, according to new research by social scientists at Case Western Reserve University.

The results of a study on the national economic impact of exposure to domestic violence—published in The Journal of Family Violence—showed higher health-care costs, higher crime rates and lower productivity in children as they aged.

“This is a significant public-health problem that not only means long-term consequences for these children, but also imposes a substantial financial burden to society,” said Megan R. Holmes, assistant professor and founding director of the Center on Trauma and Adversity at the Jack, Joseph and Morton Mandel School of Applied Social Sciences.

The Centers for Disease Control (CDC) defines intimate partner violence—more commonly known as domestic violence—as any physical violence, sexual violence, stalking and/or psychological aggression perpetrated by a current or former intimate partner.

In the United States, an estimated 15.5 million children each year are exposed to at least one episode of intimate partner violence, with more than 25 percent of children exposed to domestic violence in their lifetime.

The CDC’s National Intimate Partner and Sexual Violence Survey reports that 27.3 percent of women and more than one in 10 men (11.5 percent) have experienced physical violence, sexual violence or stalking by intimate partners at least once in their lives.

Married or cohabiting couples who have children are reported to experience the highest likelihood of domestic violence.

By the time a child exposed to domestic violence reaches age 64, the average cost to the national economy over their lifetime will reach nearly $50,000 across the following main categories, according to the research.

  • Health care: Estimated effects of domestic violence exposure on the use of hospital care and physician and clinical services.
  • Crime: The estimated effect of domestic violence exposure on the lifetime likelihood of violent crime: murder, rape/sexual assault, aggravated assault, robbery.
  • Productivity: The productivity effects of domestic violence exposure stem from a connection to lower educational attainment. Using estimates for the age-specific effects of education on worker earnings, the study calculated the expected earnings detriment associated with exposure to domestic violence.

That includes at least $11,042 in increased medical costs, $13,922 in costs associated with violent crimes and $25,531 in productivity losses.

“And that’s just for one person,” Holmes said. “If we consider Ohio’s young adults, for example, the 172,500 Ohioans who are 20 years old, the cumulative lifetime cost for the estimated 25 percent who were exposed to domestic violence as children will be nearly $2.18 billion. Applied to the entire nation, the economic burden becomes substantial—over $55 billion.”

She said the effects of children’s exposure to domestic violence carry long-lasting consequences—and society picks up the tab.

While much research has been conducted on the effect of domestic violence exposure on short- and long-term outcomes, this is the first study to add a price tag to this public health problem.

“Although we researchers often use words like ‘ground-breaking’ to describe our work, few studies really meet that bar,” said Rebecca J. Macy, editor-in-chief of The Journal of Family Violence and associate dean for academic affairs in the University of North Carolina School of Social Work.

“With their study on the economic burden of children’s exposure to partner violence however, Prof. Holmes and her colleagues have really produced a groundbreaking study.”

By understanding the extent of the costs incurred, policymakers can now reference the economics to push for more effective preventive and therapeutic interventions, Holmes added.

The study was done in coordination with Francisca García-Cobián Richter, research assistant professor; Kristen Berg and Anna Bender, both doctoral candidates, at the Mandel School; and Mark Votruba, associate professor of economics, at the Weatherhead School of Management.

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