Promoting Family Change

The optimism factor

Bronwen Elliott, Di O'Neill, Louise Mulroney

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000246957
• Edition: 1
• Topic: Psicología
• Subtopic: Psicoterapia

'This book heralds an exciting new chapter in the history of family-centred practice. It takes us a long way down the road toward the destination of strength-based family work.'From the foreword by Associate Professor Dorothy Scott, University of MelbourneLife can be a struggle for some families, and support from skilled family workers can make a real difference. Promoting Family Change is a guide to working with vulnerable and marginalised families outside formal therapy settings.Promoting Family Change introduces several approaches to family work which have proven to be very successful: solution-focused, narrative, cognitive, and community-building. These approaches assume that the starting point for change is the strengths and capacities of family members. The book is illustrated with detailed case studies drawn from actual practice, and it includes examples of innovative programs. It also looks at ways in which workers can incorporate these approaches into their practice to become more effective in their interventions with vulnerable families. Promoting Family Change is a good introduction to family practice for students and a valuable reference for welfare and community workers who wish to review and improve their practice skills. Bronwen Elliott is a social worker with wide experience in working with families and consults with a range of agencies to improve their services. Louise Mulroney has worked for the last twenty years in the field of child and family welfare, particularly in the areas of training and policy development. Di O'Neil is Director of Special Projects and Training for St Luke's Family Care in Bendigo, and co-author of Beyond Child Rescue.

one
Optimism and family work

'Most days I wonder why I bother to get out of bed. AN I can see is mess. I'm a mess, the kids are a mess, the house is a mess. What is the point?' Jen finished her story and looked at Miriam. Miriam shifted in her chair.

Jen, aged 32, was the mother of two children, Lenny aged twelve and Annie aged three. Miriam was a family worker at the local family support service. Jen was referred there when Annie's preschool contacted the statutory child protection service expressing concerns that she was being neglected.

Jen left Annie's father Ron two months ago. Initially Jen had been drawn to Ron's protectiveness but over time, as Ron sought to control the lives of all in the family, Jen and the children were subjected to violence and verbal abuse. Leaving Ron had seemed to be the answer to all the family's problems.

However, as Jen grimly observed, she had jumped out of the frying pan and into the fire. She had substantial credit card debts and was now trying to support the family on welfare payments supplemented by casual bar work. She sometimes needed to leave Lenny and Annie in the house alone at night so she could work. When she worked days she relied on Lenny to wake, dress, feed and deliver Annie to preschool. She felt Lenny had learned a lot of 'bad attitudes' from Ron, his stepfather, and had no respect for her. The family were living in a unit with a leaking roof and Jen had given up trying to keep the flat tidy. 'What's the point,' as she put it, 'when even the landlord doesn't visit?' Piles of washing covered the chairs and the floor, and the lounge room was littered with used crockery.

'Look,' said Jen, 'who could call this a life?'

Miriam could see exactly what Jen meant. Her job is to help Jen and her family find ways to feel more in charge of their lives.

Miriam is one of thousands of family workers who meet families like Jen's each week. These are families struggling with complex situations. They may be dealing, like Jen's family, with issues relating to domestic violence* child protection concerns and poverty. Other families may be affected by the mental illness or disability of a family member, or by substance abuse or addictions. As well as their present difficulties, family members may bring with them the impact of past events such as childhood experiences of disadvantage or abuse.

Optimistic Work with Families

Family workers such as Miriam form part of a network of services such as family support services, refuges, neighbourhood centres, family centres and child protection agencies supporting families. Often operating within non-government, community-based organisation, these services have different funding sources, structures and roles. However, a key characteristic found within this diverse range of settings is the optimistic attitude displayed by family workers.

Optimism in this context is not about having a naturally sunny outlook, it is not a statement about workers' personalities, nor is it a generalised hope that everything will be all right eventually. It is an active stance that looks for possibilities for change even when situations appear hopeless. Those who practise optimism in family work believe that change is possible, and that families themselves are capable of bringing about change. The worker's role in this optimistic framework is to mobilise this Capacity of the family.

For some workers this optimism is rooted in deeply held values about the capacity of families and individuals. For some it reflects personal experiences of struggle and growth, which have nurtured the belief that others can travel a similar journey. Other workers would talk about challenging labels or self-fulfilling prophecies. Regardless of the challenges they face and the different backgrounds they come from, optimism abounds among family workers.

Because these workers operate from the same optimistic framework, they share some common ideas about what are helpful ways to assist families facing difficulties.

Starting where the family is

Often family work starts literally where the family is and family workers recognise home visiting as a highly effective strategy. Starting where the family is means listening to the family's story first and finding out what is important to them. Even where the worker's involvement with the family has been triggered by the agenda of some other party, such as a statutory child protection service, the family worker's initial task is to hear the story from the family's point of view. The views of others may have to be taken into consideration in the plans the worker and the family develop, but these views cannot be an effective starting point if the family perspective has not been heard.

Developing respectful relationships

Workers in the helping professions accept the vital importance of respectful relationships in theory. In practice, maintaining respectful relationships can be hard work, especially where clients may have had little experience of being respected themselves. Persisting with respectful behaviour in the face of aggression and hostility, when clients lie or abuse trust or when their actions are damaging to other family members, takes patience.

Family workers may draw on their own life experiences to find encouragement to keep working on respectful relationships. They have their own experiences of struggle with difficult family issues, relationships and parenting. This recognition challenges the 'us and them' view of clients, which can lead to denigrating clients overtly or implicitly, and to limiting workers' beliefs about the potential for change.

Setting goals

Often contact with a family worker is the first time families have been able to tell their story to someone and really feel that they have been heard. Such contact is the base from which family workers can find out what the family's biggest concerns are and help them set some goals for addressing these. Families may be overwhelmed if they have to do too many things at once, so it is important that workers encourage families to start with small steps and negotiate new goals once some of the earlier ones have been achieved. When families are caught up in the chaos of multiple problems, setting goals can encourage a focus on looking for success, not on what is going wrong.

Helping in practical ways

Family workers recognise the value of assistance with practical problems. This could mean finding a way to obtain a cheap washing machine and working out how to get the washing done in the meantime. It may mean going shopping or getting legal advice alongside a parent as a way of teaching skills. Family workers try to find a balance between reducing stress in the family and teaching skills that can help their clients address difficulties independently in the future.

As well as the immediate value of addressing the family's most urgent concerns, working together to solve a practical problem provides an opportunity for the family worker to develop a stronger relationship with the family, and to find out more about family members' concerns and the way they work together.

Building networks

Isolation has a significant impact on families. If parents do not have access to extended family support, if they do not have friends locally, or do not know what services are available, the task of parenting will be much harder. Family workers seek to break down isolation in various ways. Families may be invited to playgroups or coffee mornings, which give them the opportunity to meet other local parents. Services may run groups with a specific focus, such as groups for survivors of domestic violence or parenting groups.

Family workers also provide information about other services that may be relevant to the family and can help the family to gain access to specialised assistance. This may involve addressing practical obstacles such as lack of transport or child care, or other barriers such as suspicion or anxiety.

Building on strengths

Optimistic family work is oriented towards identifying the strengths and resources within families and using them as the base on which new skills and approaches can be developed.

Other approaches to working with families look for change to come from an in-depth exploration of the family's problems and deficits. Such explorations can include looking for the origin of problems, placing problems within categories and using knowledge based on the study of similar problems to expose related problems and predict outcomes.

However, a strengths-based approach doesn't assume a connection between the knowledge about problems and working out what to do about them. In contrast, workers using this approach assume that change is more likely if it can be built on what exists within the family already, rather than being imported from outside.

Challenges to Optimism

Two months after their first interview, Miriam again climbed the steps to Jen's flat. Miriam knew she had worked hard since their first meeting, but felt dissatisfied with what had been achieved. She had spent a long time talking to Jen, and had heard a lot about Jen's life. She wondered whether hearing Jen's story was helpful as each time they talked Jen seemed to have discovered more to regret.

Miriam tried to set goals with Jen, but each time she visited there seemed to have been a new disaster and Miriam found it hard to maintain a sense of direction. At first it seemed the most important thing was to find alternatives to Lenny and Annie being left at night, since the statutory welfare authorities were concerned about their safety. Then Jen lost her job, so this issue was resolved, but the family faced further financial pressure as a result.

Miriam found it hard to find anything that Jen felt was worth working on. She suggested a group for parents of teenagers and Jen attended the first two sessions, but then decided the problem wasn't Lenny, it was her, so the group couldn't help. Jen didn't want to find out about counselling services, saying, 'What would they know? They couldn't help me.' Miriam suggested a craft group, but Jen wasn't interested in craft. Miriam tried to interest Jen in developing routines for the housework, but Jen fell there was no point when the house was such a mess. Miriam passed on information about Jen's rights as a tenant, but Jen couldn't decide whether to follow this up or simply to move when her lease expired.

Miriam wondered why Jen was still keen to see her and found herself half hoping that Jen would forget their appointments or send her away because she hadn't been able to help. She was starting to find that Jen's despair was contagious.

Most, if not all, family workers have had experiences like Miriam's. Like Miriam, they have questioned the value of their work, and wondered whether there were any grounds for optimism about a family like Jen's. In recent years they may have asked these questions more often because of major shifts in the provision of services to children and families.

Several decades ago the frequent response to struggling families was to remove the children from the family and place them in institutional or foster-family care. In the 1970s a range of factors contributed to the development of policies and services aimed at the prevention of placement and the reunification of children who had been removed from their natural family (Scott and O'Neil 1998, p. 24).

For the family support services that began to develop at this time, the initial focus was often on early intervention and prevention of family breakdown. Staff did not necessarily have academic qualifications, but they brought with them the intuitive helping skills they had acquired as family members, carers, and paid or volunteer community workers. The confidence and optimism of staff was fuelled by the success they experienced in their work with families. They used what worked, and it was no great surprise to those who subsequently gained formal qualifications when their tertiary studies confirmed what they already knew were effective practices with families.

However, as the value of family support gained wider recognition, services found their staff were working with families coping with more complex situations. Instead of seeking to prevent family difficulties, staff were working with families who were neglecting or abusing their children, and where there were complex relationship difficulties. Often families were facing major financial and social disadvantages, complicated by other factors such as drug or alcohol use, or mental health issues. Because of their ability to work with families in their homes, and the flexible mix of services they offered, family workers often found themselves working with families that more specialised agencies had difficulty reaching.

In this changing context, family workers found that their ideas about what worked with families often did not take them far enough. They might be able to engage the families who were now being referred to them, to hear their stories, and perhaps to offer some practical help. But support was not necessarily enough for these families. Sometimes workers felt that by supporting the family they were not helping.

At times family workers found they seemed to be putting more work into the change process than the families themselves. Sometimes the more the family worker did to help, the less the family seemed committed to and involved in the work being done. The family worker could be exhausted, but the family situation remained the same. Something needed to change if family members were to stay together and stay safe.

Taking Optmism Further

Family workers have drawn on the following four approaches to assist them in taking optimism further in their work with families:

• solution-focused
• narrative
• cognitive
• community-building.

A summary of these approaches is provided in chapter 2. They have been chosen because of the place they have in family work in Australia at the present time. Four factors influence this choice.

1. These approaches are widely used in family work agencies. As well as anecdotal evidence of this, the 1998 census of the Family Support Services Association of NSW reported extensive use of narrative, solution-focused and cognitive behavioural therapy by family workers employed in 140 organisations in NSW. The same census reported that 75 per cent of these organisations engaged in community-building activities as part of the family work program (Family Support Services in NSW 1998, pp. 14, 15).
2. The value of these approaches is widely recognised in family and community services. They are well documented, have influenced family work in a number of countries, and are supported by an extensive practice literature. Reading lists are provided at the end of the chapters detailing each approach.
3. These approaches have been relatively recently adopted by family services. Hence the way in which they have been introduced into organisations within the last decade can be charted and the challenges they have presented can be documented.
4. These approaches are each based on an optimistic framework. Each builds on the same basic assumption that people have the capacity to make change happen, no matter how challenging the situation they may be in. Each of these approaches therefore emphasises the competency of workers to mobilise and build on the resources within families, rather than emphasising specialised knowledge, expertise or insight of workers to create change.

The selection of these approaches should not be taken as evidence that they are proven as the most effective approaches available to family workers. Overall, little research has been undertaken into the effectiveness of these approaches, particularly in the context of family work as opposed to more formal therapeutic settings. The cognitive approach has been extensively evaluated in formal settings, and has been demonstrated to be an effective treatment for depression and other specific difficulties. These studies have not been replicated in a family work setting, and the nature of family work with its attention to the broad range of family issues would make it somewhat difficult to do so.

Although the effectiveness of the com...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Foreword
• Acknowledgements
• Introduction
• 1 Optimism and family work
• 2 Four optimistic approaches to family work
• 3 Solution-focused work with families
• 4 Narrative approach to working with families
• 5 Cognitive work with families
• 6 Community building and family work
• 7 Working within one approach
• 8 Beyond technique: optimism in practice
• 9 Optimism on another level: working with other agencies
• References
• Index