Child Protection and the Care Continuum

Theoretical, Empirical and Practice Insights

Elizabeth Fernandez, Paul Delfabbro

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000281415
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

This important new book critically examines the complex policy and practice issues surrounding child protection, including the impact of theoretical orientations, contemporary debates, policy initiatives and research findings, and maintains an emphasis on the ethics and values underpinning child welfare interventions.

The book introduces policies that are central to understanding the position and needs of children and young people, and how policy and practice have been influenced by developments including the children's rights agenda. It also explores the most significant issues in child welfare. These include: the experience of maltreatment by children, the systems of child protection to safeguard them, the methods and challenges of risk assessment, and the wide range of policy and therapeutic interventions to respond to children's needs. The book also examines family support to promote children's wellbeing before considering provision for children and young people who are looked after in out-of-home care. There is also a final section that focuses on best practice in communicating and working with children and young people, drawing on participatory, rights-oriented and resilience-based approaches, and supporting foster and adoptive carers and biological parents.

Contributing in a substantive and clear manner to a growing international conversation about the present function and future directions for child welfare in contemporary societies, this textbook will be of interest to undergraduate and postgraduate social work students and those from allied disciplines, and professionals who are engaged in child welfare services.

Part I

The context of child and family
welfare

Chapter 1

Policy and trends in child welfare in
Australia and the global context

Elizabeth Fernandez and Paul Delfabbro

Introduction

Family and child welfare policy and practice reflect society’s organised concern about the intrinsic worth of the child and the family, and the rights of the child as a developing person and citizen. The field of family and child welfare is confronted with challenges to respond to complex problems, including the increased official reporting of child abuse and neglect and the care and protection of children and young people. Evidence of community outrage at media accounts of children who have been abused physically, emotionally and sexually, or neglected, and the inability of the child welfare system to prevent maltreatment or protect children either in their own families or in public care have influenced directions of child welfare policy and practice. However, the child protection system operates in a complex environment where decision making often requires interdisciplinary knowledge; legal understanding; psychological and sociological insights; analytical skills; and, reflective ethical practice. As will be shown in this book, the policies and services designed to protect children and support families are constantly evolving in response to these challenges and debates. Policymakers and practitioners are confronted with difficult decisions that have far reaching consequences for children and families.

Safeguarding children who are maltreated and who need protective care is a central element of child welfare. For example, the definition and scope of maltreatment, its cause, and how it should be responded to are the subject of continuing international and national debate. At what point or threshold should care be considered inadequate or abusive? Some commentators have argued that the definitions of maltreatment applied to families are too broad, exposing families to unwarranted intrusion through investigative processes (Besharov 1985; Gibbons, Conroy & Bell 1995; Munro 2011), whereas others have argued that many families do receive adequate interventions. These dilemmas confront child protection systems internationally and are equally relevant to child protection policy and practice in Australia.

The child welfare continuum

Child welfare systems are often described as providing a ‘continuum’ of services and supports for children affected by child abuse and other related problems. The term continuum refers to the scope and intensity of the intervention or the degree to which the state is required to intervene to protect children from harm. The priority in this continuum is the provision of family-based services to enable families and children to remain together. Interventions can range from the notification or recording of abuse incidents; to investigations and substantiations; to the provision of services that involve the state in the lives of children and families, including removal of children from their families and placement into other arrangements. Interventions often involve a range of parties including the court system, child welfare services, non-government organisations and those who provide the care itself (e.g. foster carers and kinship carers and adoptive parents). Even within these different levels of the system there can be variations in what might be considered a ‘continuum’ of service options. For example, in out-of-home care, children can be placed with their relatives or with strangers (foster care), but there are also more institutional forms of care (group homes, residential care) where the environment is less similar to the child’s home or family environment. Services can also vary in terms of the level of resources applied to each case or intensity of intervention provided (Whittaker, del Valle & Holmes 2015). Some children may go into out-of-home care with few additional supports, whereas others may receive therapeutic interventions and a constellation of different services.

Child maltreatment

In the last five decades of child welfare history and policy, child maltreatment has been a major focus of concern. The ‘discovery’ and growth in concern about child abuse since the 1960s has been the subject of an expanding international literature which has documented the emergence of it as a social concern and how it might be addressed. In the 1960s Henry Kempe and his colleagues, focusing on extremely brutalised young children, drew attention to what was labelled the ‘battered child syndrome’ (Krugman & Korbin 2013). Initial conceptualisations of the problem of maltreatment as ‘the battered child’ syndrome in the 1960s reflected a narrow definition of child maltreatment. This definition has since expanded to include physical neglect, emotional abuse, sexual abuse and organised abuse. Constantly widening definitions of child abuse have seen the phenomenon of physical battery expand to include neglect, emotional abuse and sexual abuse (Cooper 1993) and a consequent expansion of the grounds on which the state may intervene.

A further influential factor in the mobilisation of the child protection agenda was the rise of the ‘women’s movement’ in the late 1970s. This movement added political momentum to the recognition of the problem of sexual abuse (Finkelhor 1996) and resulted in greater recognition of the importance of family safety and domestic violence (Parton 1990). As women’s representation in the government and higher status professions such as medicine, law and health increased, they brought with them their interest in children and sensitivity to child welfare concerns increased. The children’s rights movement of the 1980s gave further impetus to the child protection agenda. Other important developments have been the effect of children’s exposure to domestic violence and parental drug and alcohol misuse (Cleaver et al. 2007) as well as recognition of the simultaneous exposure of children to multiple forms of maltreatment or polyvictimisation (Clemmons et al. 2007).

A large body of international research has shown that childhood exposure to physical, sexual and emotional abuse impacts developmental outcomes and contributes to impaired mental health in adulthood (Buckingham & Daniolos 2013; Fernandez & Lee 2017; Finkelhor et al. 2007; Gilbert et al. 2009; Nurius et al. 2007). Trauma from childhood maltreatment causes debilitating emotional and behavioural difficulties in children and can affect their ability to cope while in care, and can lead to adverse outcomes for older youth transitioning out of the care system (McMillen et al. 2005). In support of this view, Australian research quantifying the burden of psychological disturbance attributable to multiple forms of maltreatment concludes that a significant proportion of depressive and anxiety disorders and intentional self-harm is attributable to maltreatment in childhood (Moore, McArthur & Noble-Carr 2015).

All of these developments have occurred in the context of ongoing debate about the definitions and causes of abuse. The international child welfare literature is replete with definitions and typologies of specific types of maltreatment (Corby et al. 2012). These definitions, often presented in statutes and in the literature, are usually descriptive of incidents constituting abuse. In a legal context, the definitions adopted can influence reporting requirements; decisions about state intervention involving removal of children to care; and, even the termination of parental rights. More broadly, the definitions and understanding of child abuse have expanded beyond the family to encompass internationally recognised problems such as child sexual exploitation, child pornography, child trafficking and institutional abuse.

Meanwhile, at a basic practice level, child neglect continues to be the most frequently occurring form of abuse faced by child protection systems. The psychological and physical consequences of neglect are widely documented (Erickson & Egeland 2002). Neglect has had a low profile in professional and public awareness relative to physical and sexual abuse, with neglect cases often being filtered out of the system at various thresholds. Further, neglect has been portrayed as almost indistinguishable from the effects of poverty (Stevenson 1989). Research repeatedly highlights the association between maltreatment and low-income families and neighbourhoods and the potential for social inequalities to have an impact on the incidence of maltreatment, and for service responses to reinforce and exacerbate such inequities for children and families (Bunting et al. 2018; Bywaters et al. 2015; Coulton et al. 2007; Donelan-McCall, Eckenrode & Olds 2009).

The broad association of poverty with increased rates of neglect as well as other forms of abuse draw attention to the fundamental importance of understanding the extent to which abuse arises from structural or broader socio-economic factors as opposed to those which are attributable to individual characteristics of families: their decisions, choices, behaviours and disposition. For example, if abuse is seen to arise largely from structural factors, it implies that significant improvements might be achieved through preventive and supportive approaches. Accordingly, there have been calls for child protection systems to respond differentially to cases involving substantial risk and those situations where families are in need of services and family-based interventions. Such tensions are evident in the literature relating to the definition and causes of abuse. For example, early discussion of abuse favoured definitions that illuminate abuse at the institutional and structural levels as opposed to the exclusive legal focus on individual culpability. Abuse was defined as ‘inflicted gaps or deficits between circumstances of living which would facilitate the optimal development of children to which they should be entitled and their actual circumstances, irrespective of the sources or agents of the deficit (Gil 1975: 346). Such a broader approach to definition highlights the structural bases of maltreatment and has the potential for intervention that enhances the quality of life for all children. The link between structural disadvantage and child maltreatment has been underscored. That child maltreatment occurs across the spectrum of family income and education, or that some forms of child maltreatment are more explicitly linked to socio-economic stress is acknowledged (Pelton 2015; Welbourne 2012). However, through the 1990s commentators have affirmed the need for a more comprehensive strategy which is child-centred, family-focused and neighbourhood-based (Berger & Slack 2014; Garbarino & Barry 1997; Melton & Barry 1994) and which involves a range of systems: physical and mental health, education, justice, housing and income support, in achieving a broader safety net for all children.

Historical context and trends in child protection

In the mid-1970s there was a re-emergence of state and media interest in the incidence and severity of child maltreatment, and children at risk of abuse became a major focus of all Statutory Departments. In response to the increased identification of child abuse and well publicised cases of maltreatment, such as Colwell in Britain (Parton & Martin 1989) and Montcalm in Australia (Lawrence 1983), a strong interventionist stance re-emerged and there was a proliferation of directives and safeguards to ensure early detection and prompt action in dealing with child abuse and neglect. Despite the broader long-term trends, there can be significant variations between jurisdictions based upon the drawing of thresholds. Nevertheless, it is thought that there has been a lowering of thresholds for defining abuse and sanctioning intervention over time; an outcome resulting from increasing emphasis on children’s rights, the influence of the feminist theories about victimisation and societal expectation and endorsement of state intervention in family life (Fernandez 2005). One of the particularly influential factors has been the adoption of the policy of mandatory reporting which has been an integral part of the child welfare agenda to further ensure children’s safety and wellbeing.

In support of this view, the pattern of reporting abuse and neglect reflects a striking increase over time. In Australia over 2017–2018 396,000 notifications or reports of child abuse were recorded. An estimated 245,000 children were the subject of these notifications (AIHW 2019). Children may be involved in multiple statutory notifications in a year. During the period 2012–2013, 272,980 notifications were received involving 184, 216 children, and representing a 98% increase in reports over a decade (AIHW 2014). Of the notifications in 2017–2018, 37% (146,000) were judged to require further investigation, while 63% were referred to support services. The rate of children who were subject of notifications rose from 37.8 per 1000 children in 2013–2014 to 44.4 per 1000 children in 2017–2018. Other statistics show that the rate of children who were subject of a substantiated notification rose from 7.2 per 1000 children in 2013–2014 to 8.5 per 1000 children in 2017–2018 (AIHW 2019). Children who were subjects of substantiation were most likely to be from the lowest socio-economic areas (36% in contrast to 5% in the highest). Aboriginal and Torres Strait Islander (ATSI) children are vastly overrepresented in substantiations at 42 per 1000 children compared with 6.5 per 1000 for non-Indigenous children, reflecting seven times the rate of non-Indigenous children.

In 2017–2018 emotional abuse was the most common primary type of abuse substantiated (59%), followed by neglect (17%), physical abuse (15%) and sexual abuse (9%). Variations are evident in the substantiations of different types of abuse in different states with differential policies across state jurisdictions accounting for variations. While these data point to a perceived escalation in the incidence of maltreatment, they are indicative of increasing professional and community awareness of...

Table of contents

• Cover
• Half Title Page
• Title Page
• Endorsements
• Copyright
• Contents
• List of illustrations
• List of contributors
• Foreword
• Acknowledgements
• Part I The context of child and family welfare
• Part II Child abuse and neglect
• Part III The protective care continuum
• Part IV Children, parents and carers as stakeholders
• Index