Parent Perspectives on Factors that Facilitate Reunification

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Parent Perspectives on Factors that Facilitate Reunification

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1. Parent Perspectives on Factors that Facilitate Reunification Stephanie Bryson, Ph.D. Michelle Levy, AM University of Kansas School of Social Welfare

2. What Do Parents Say Helped Them to Reunify With Their Children?

3. Mental Health and Substance Abuse Services to Parents of Children in Foster Care   Stephanie Bryson, Ph.D., Project Coordinator Michelle Levy, AM, Research Associate Kathleen Holt, MSS, Training Coordinator Terry Moore, MSW, Principal Investigator Thomas McDonald, Ph.D., Co-Principal Investigator           This project was supported through a contract with the Kansas Department of Social and Rehabilitation Services Division of Health Care Policy - Mental Health Services Larger study focused on the common and multi-faceted challenges in providing services to child welfare-involved parents with mental health or substance abuse issues. In 2006 GAO report, states reported that the most important challenge to improving outcomes for children was providing mental health and AOD services to families. In Kansas’ most recent CFSR, federal reviewers judged the state’s performance on Well-Being Outcome 1: Families have enhanced capacity to provide for their children’s needs as an area “needing improvement.” Specifically, the CFSR Final Report noted, “The concern identified in the 2001 CSFR regarding lack of adequate service delivery systems was also noted in the 2007 CSFR with regard to [substance abuse, mental health, and family-focused] services to parents.” Larger study focused on the common and multi-faceted challenges in providing services to child welfare-involved parents with mental health or substance abuse issues. In 2006 GAO report, states reported that the most important challenge to improving outcomes for children was providing mental health and AOD services to families. In Kansas’ most recent CFSR, federal reviewers judged the state’s performance on Well-Being Outcome 1: Families have enhanced capacity to provide for their children’s needs as an area “needing improvement.” Specifically, the CFSR Final Report noted, “The concern identified in the 2001 CSFR regarding lack of adequate service delivery systems was also noted in the 2007 CSFR with regard to [substance abuse, mental health, and family-focused] services to parents.”

4. Parent Experience with Foster Care “Parents’ perceptions of and involvement in various services in which they must participate in order to recover children from foster care is largely unstudied.” (Alpert, 2005) Purpose of the study to describe parent experiences seeking services and to better understand what services and factors lead to successful reunification outcomes.Purpose of the study to describe parent experiences seeking services and to better understand what services and factors lead to successful reunification outcomes.

5. Recruitment for Parent Interviews Case workers, treatment providers, self-referral Participant Criteria: 1) child(ren) in out-of-home care 2) received services (substance abuse and/or mental health) 3) successfully reunified (defined roughly as one year) Targeted recruitment - racial/ethnic identification, geographic residence, fathers

6. Interview Process Most interviewed in home, some at agencies Completed Parent Services Questionnaire Semi-structured interview Paid $30 for participation

7. Parent Demographics 23 mothers and 7 fathers Age ranged from 27 to 53 White/Caucasian (25); Hispanic (2); Bi/Multi-Racial (2); African–American (1) Geographic Distribution

8. Services Utilized By Parents Of 28 parents who completed questionnaires: 19 participated in AOD outpatient 14 participated in AOD inpatient treatment 19 participated in an AOD support group 11 received individual counseling at CMHC 12 received counseling from private provider 15 participated in family therapy 12 participated in group therapy 18 attended a parenting group 5 participated in a parent support group

9. Main Findings-What Helped? INCLUSION IN CASE PLANNING ONE SUSTAINING RELATIONSHIP MEETING UNDERLYING NEEDS

10. Inclusion in Case Planning “SRS wrote the initial court report. Now how can they do that if they aren’t doing the work? They don’t know about me. They don’t know what’s going on.” Parents were asked to describe the process for deciding what services were needed in their case. Many parents related that services were determined by child welfare professionals. In other cases, parents reported that they were given the opportunity to weigh in on goals and plans related to services for themselves. Parents were asked to describe the process for deciding what services were needed in their case. Many parents related that services were determined by child welfare professionals. In other cases, parents reported that they were given the opportunity to weigh in on goals and plans related to services for themselves.

11. Inclusion in Case Planning Initial assessments comprehensive Included step-parents Included child and family strengths Acknowledged intergenerational issues, esp. trauma Recognized parent AOD, MH, DD USED input from parents

12. One Sustaining Relationship Case managers, substance abuse counselors, parents, siblings, friends, therapists, foster parents, work supervisors, their children Higher power/spiritual source Characterized by: High warmth, low criticism “For me, not against me” Sustained parents’ hope & motivation, esp. with AOD Often long-term Often went beyond original professional roles

13. Nonjudgmental Approach “People that don’t do drugs or haven’t ever been like that are not very forgiving. They don’t think that people should have second chances. It’s not just somebody screwing off all their responsibilities and not taking care of kids. It’s the problem of drugs having addiction over your body. You can’t control it. They say that it turns into disease. It takes priority over everything because without it, I can’t function.”

14. Nonjudgmental Approach “I am more willing to work with people if they treat me like a human being. I’ve made mistakes. I’ve made bad choices, but I’m not a bad person. I love the heck out of my kids. I’ve made bad choices. My provider worker talks to me like a person, and she helps me and gives me good feedback and helps me address my issues that I deal with on a day to day basis.”

15. Recognizing Strengths “When you’re in treatment, you already feel this big. You feel like a failure. There is nothing successful about you. When you come out of treatment, you are scared as hell.” “We’ve always done family things: bowling tournaments, hunting, and fishing—as a family. At our house there are trophies and pictures of the kids on walls at the bowling tournament but the workers didn’t seem to notice. We even did this when I was using.”

16. Recognizing Strengths “You lose all credibility at the beginning. A different worker was what made a difference, a softer approach. After each visit, she recognized the positives and negatives. They point out good things at visits. She showed that me and the kids had a good relationship before they were taken. We had something worth working toward.”   “Our two brand-new caseworkers…they did a good job. They would see me and they would make sure they stopped and spoke and they didn’t belittle me and judge me.”

17. Meet Underlying Needs Domestic violence/trauma histories Substance abuse/mental health Poverty/financial problems Transportation/visitation

18. Underlying Needs: Trauma, MH, AOD Treatment Treatment programs that acknowledge trauma and its effects Appropriate MH treatment for symptoms of PTSD, including medication Non 12-step programs “It is so hard for women who have domestic violence to turn over that powerlessness because we’ve already had to do that.”

19. Underlying Needs: Money, Means, Motivation  Financial Barriers “Coming out of jail and losing everything: house, car. We did not get personal belongings back.” Transportation “When you are trying to help yourself and you want to see your kids, it is one of the most heart-aching things not being able to see your kids because of transportation services.” Parent motivation/desire to change “Treatment will not help if the person is not ready to make a change. You might as well take your money and throw it in the street.”

20. Recommendations from Parents Respect and Recognition of Individual Families “I’d like to see my thoughts, my feelings, and my beliefs being heard and being respected.” “Give me the chance to make a choice. Don’t make my choice for me based upon what you think should be the situation.” Improved Communication “I needed] more communication about what was going on because I really had no clue about what was going on.” “More contact with SRS…The contracting agency and SRS need to get on the same page, have more communications, more open communications.”

21. Recommendations from Parents  Access to Services “Make them more aware and more available…Things should be more accessible. Letting people know that there is help.” Timely Visitation “You need so many days of sobriety before you can see your kids. If you’re in treatment, they should let you see your kids. When you’re in treatment you feel like everything is being taken away. You are starting to realize, I don’t have clothes, a vehicle, a place to live…It’s overwhelming.”  

22. Recommendations, continued Support for Parents “Groups for mothers trying to get their kids back. You get to where you feel alone and nobody understands, and nobody’s got it like I do.” “Making parents be able to visually see people who have made it and got their kids back. It should be mandatory for parents to get together once a month and talk, exchange resources. In treatment places, you can see all these other people that it’s happened to. For me, it challenged me. Support is a big thing. You’ve lost everybody already. Being an addict, you don’t get someone overnight. You’re scared and you don’t know where to begin. They give you this big booklet and you think, ‘Oh Jesus.’ If they had a group like that I would go to it.”

23. Advice to Parents  “The only reason I stayed in the system and did what I did was that I wanted my baby back. At any cost. I would have done anything.”  “You can go home and cuss and fume all you want, but when they ask you to do it, you need to do it. You need to build their trust and respect. It’s not going to work if you don’t. You need to just buckle down and do what you need to do. If you want your children back, suck it up and do what you’re supposed to do.”  

24. Advice to Parents  “I treated it like a job. I did it for this little face in front of me.” “When it was all said and done, I asked to say something. I said, ‘You know, I want to thank you for making me go through all this. It has changed my life. I’ve grown as a person. My daughter has grown as a person.’”

25. Thank You! Stephanie Bryson [email protected] Michelle Levy [email protected] Special thanks to our parent panelists: Maria, Sarah, and Lisa!!!

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