Child welfare systems in crisis – the ‘why’ of Family Inclusive practice

There are high and growing rates of children in care across Australia driven by growing periods of time in care (Australian Institute of Health & Welfare, 2019). It is widely accepted that children should be at home with their families whenever this is safe and that helpful services are needed to achieve this. All Australian jurisdictions have a primary goal, at least in theory, of ensuring that children get the opportunity to be raised by their own families unless there are pressing safety reasons for permanent removal. Despite this, Australian child welfare systems have not reduced the numbers of children in care over time (Australian Institute of Health & Welfare, 2019), especially in relation to Aboriginal and Torres Strait Islander children where trends are particularly poor (Family Matters, 2018).

Despite its importance, there is little reliable data on reunification rates in Australia collected by state and territory governments (Australian Institute of Health & Welfare, 2019). When data are available in individual jurisdictions, it is unclear what it means as it is combined with data on all exits from care including when legal orders expire (Family Matters, 2018). There is evidence suggesting that reunification rates may be low in Australia, especially for children who have been in care for longer than a few months, for young babies and for Aboriginal and Torres Strait Islander children. One large study in New South Wales found that the reunification rate after 2 years, for 1834 babies removed at birth, was as low as 6.9% (Marsh, Browne, Taylor, & Davis, Reference Marsh, Browne, Taylor and Davis2017). An earlier study in South Australia (Fernandez & Delfabbro, Reference Fernandez, Delfabbro, Fernandez and Barth2010) found that although reunification rates were around 36% within 8 months of care entry (this study included all entries to care in that state over a 12-month period in 1999–2000), the chances of reunification rapidly fell after that time. South Australian Aboriginal children in the same study were five times less likely to be reunified. Nationally, Aboriginal and Torres Strait Islander children are around 11 times more likely to be in out of home care, part of a long-term trend of increasing disproportionality (Australian Institute of Health & Welfare, 2019). The high rates of Aboriginal and Torres Strait Islander children in care have been described as a national crisis, which echoes the experiences of the Stolen Generation (Family Matters, 2018; SNAICC, A National Voice for Our Children, 2017).

Even when children remain permanently in care, they benefit from ongoing family involvement in their lives and enduring relationships with family. There is evidence that children who leave permanent care with at least some family relationships intact have better outcomes (Cashmore & Paxman, Reference Cashmore and Paxman2006; Mendes, Johnson, & Moslehuddin, Reference Mendes, Johnson and Moslehuddin2012). Children in care who are able to maintain and strengthen their pre-removal family relationships experience less grief and loss as they effectively do not lose their parents, siblings and other family relationships. This helps develop a sense of ongoing security, and a sense of belonging to both their original families and the families with whom they live (Biehal, Reference Biehal2014; Boddy, Reference Boddy2013). Children who have high quality contact with their families are more likely to experience stability in care and to be reunified (Boyle, Reference Boyle2017; Sen & Broadhurst, Reference Sen and Broadhurst2011; Zabern & Bouteyre, Reference Zabern and Bouteyre2018). Children and young people living in residential care also benefit from ongoing relationships and family involvement (Boel-Studt & Landsman, Reference Boel-Studt and Landsman2017; Huefner, Pick, Smith, Stevens, & Mason, Reference Huefner, Pick, Smith, Stevens and Mason2015). Family relationships contribute to children’s lived experience of permanence and felt security (Samuels, Reference Samuels2008). When asked about how they felt about permanency, young people in California felt that relationships, including family relationships, were more important than legal orders, or the permanence of physical living arrangements (Sanchez, Reference Sanchez2004).

The evidence suggests that quality family relationships are important for children and young people in care, regardless of where they are living and especially if they are to be safely reunified. Family Inclusive practice has the potential to contribute positively to this.

Element one – The acknowledgement and amelioration of power imbalance

Even with the best intentions, relationship-based practice will not thrive in a power-laden practice context. Parent and family distrust of the system is increasingly being acknowledged by child welfare authorities themselves (Office of the Senior Practitioner, 2011, p. 7). Instead of seeing distrust as a parental attitude that inhibits engagement, as may occur in more conventional understandings of family engagement discussed earlier, a Family Inclusive approach acknowledges the rationale behind that mistrust and that power imbalances fuel that distrust.

I visited the Centre for Improvement in Child and Family Services at Portland State University. The centre has developed a contextual understanding of family engagement that integrates anti-oppressive practices with a motivational approach. Engagement is conceptualised as a reciprocal, relationship-based process that occurs over time and involves a range of stakeholders and systems (Furrer & Rockhill, Reference Furrer and Rockhill2017). The team at the centre has identified four common areas of coercive and oppressive practices in child welfare. They argue that these practices are experienced as oppressive and unjust by parents and family and do not appear to support children’s relationships with their families. By identifying and ending these practices, whenever possible, we are contributing to a more inclusive approach.

1. (1) Surveillance. Parents, family and children are subject to ongoing surveillance including enduring family visit supervision, drug testing and unannounced home visiting. These practices are rarely helpful to families and children in themselves.

2. (2) The control of information. These practices include the documentation of material in ways that may highlight family and child deficits at the expense of strengths, use jargon and have a lack of transparency about what families need to do to meet the requirements of child welfare workers. Information in child welfare can be provided in selective and controlled ways. For example, meetings presented to families as opportunities for discussion but are, in reality, conducted primarily for child welfare authorities to pass on decisions that have already been made.

3. (3) The application of a dominant narrative that can drown out the strengths and perspectives of children and families. For example, there is a pervasive ‘hero’ narrative in child welfare in which child welfare workers protect children from dangerous families and are able to accurately prioritise children’s interests over the interests of other stakeholders.

4. (4) Child welfare systems are dominated by rules, policies and processes which lack transparency and can be bewildering to parents and families. They are also used as a reason to avoid inclusion as the administrative demands of work are claimed to disallow it.

Acknowledging that power imbalances exist at all is an important step towards Family Inclusive practice, but it is not enough. To be Family Inclusive, we need to create and effect mechanisms that genuinely challenge injustice, transfer power and hold practitioners accountable. A key strategy being used in the USA in particular is peer parent advocacy. Peer parent advocates are defined by Lalayants (Reference Lalayants2014) as parents who have had personal experiences in the child welfare system and offer advocacy and support to parents newly involved in the system. Peer parent advocates have particular skills and expertise based on their lived experience – they have ‘built their knowledge from their everyday trial and error experiences of working the system’ (Brown, Reference Brown2006, p. 369, cited in Lalayants, Reference Lalayants2014, p. 108).

Peer parent advocates I met with in Oregon, California and New York City intentionally did not keep notes that might be used against families, and some had arrangements in place with the courts to help prevent them from being called to give evidence against parents. In a system where most interactions with families and children were documented and characterised by surveillance, any helping relationship without scrutiny served as an important source of respite and emotional support. It also worked to reduce power imbalances as parent advocates were able to share what they know about the system and provide emotional support and coaching that enabled parents to communicate more effectively in power-laden situations, without fear that what they said to parent advocates might later be used against them in legal proceedings.

Services in New York City have been delivering legal services using a multi-disciplinary model comprising specialised lawyers, social workers and peer parent advocates for some years (Action Research Partners, 2017; Ketteringham, Cremer, & Becker, Reference Ketteringham, Cremer and Becker2016). Parents are represented by lawyers who specialise in family defence as part of the multi-disciplinary model, alongside social workers and parent advocates who provide practical and emotional support and advocate for appropriate services from the child welfare system (Bronx Defenders Office, 2019; Centre for Family Representation, 2017). Parents in New York City who received multi-disciplinary family defence representation never had to meet with statutory agencies without an advocate by their side, directly addressing power imbalances. This model has now been subject to evaluation on a large scale, involving almost 10,000 families. The evaluation found that compared to conventional legal services, children with families accessing the multi-disciplinary model experience shorter stays in care and are more likely to be reunified (Gerber et al., Reference Gerber, Pang, Ross, Guggenheim, Pecora and Miller2019).

The integration of purposeful acknowledgement and amelioration of power imbalances including legal representation combined with social work and peer parent advocacy have increased worker accountability and enabled parents and family to build relationships with child welfare workers. A senior leader from the Administration of Children’s Services in New York City shared with me his view that strong advocacy for parents had improved relationships with families.

Peer work has been successfully implemented and evaluated in Australia as a preventative, non-statutory service in child welfare relying on volunteer families. This has been linked to a range of positive outcomes including reduced referrals to statutory child welfare (The Australian Centre for Social Innovation, 2012). The local success of this preventative model, aimed at preventing escalation and removal, suggests that peer work in statutory child welfare services, including after children have been removed, also has potential to increase reunification rates and reduce stays in care.

Element two – Addressing the social causes of harm to children and child removal

It is well established in Australia and in the countries I visited that there are complex social causes of harm to children and child removal. The plight of Aboriginal and Torres Strait Islander children has already been mentioned and there are similar problems in Canada (Aboriginal Children in Care Working Group, 2015). Children living in rural areas and areas of low socio-economic status are also over represented (Australian Institute of Health & Welfare, 2019). A range of social problems including poverty, homelessness and social isolation have been linked in the literature to the experience of child abuse and neglect (Bywaters, Brady, Sparks, & Bos Reference Bywaters, Brady, Sparks and Bos2014; Raissian & Bullinger, Reference Raissian and Bullinger2016), to removal, and to lower rates of reunification (Fernandez, Reference Fernandez2018; Fidler, Reference Fidler2018). Being Aboriginal or Torres Strait Islander, a sole parent, a care leaver and being a young parent are all factors linked to child removal in Australia and have also been linked to lower rates of reunification, reduced contact with family while in care and recurrent removal (Delfabbro, Barber, & Cooper, Reference Delfabbro, Barber and Cooper2002; Fernandez, Reference Fernandez2018; Fernandez & Delfabbro, Reference Fernandez, Delfabbro, Fernandez and Barth2010; Hinton, Reference Hinton2018).

Most practitioners know from experience that deprivation, unstable housing and other social issues are part of life for almost all families who experience child removal. In a comprehensive study of child welfare inequalities across four countries, UK research found that child welfare workers felt powerless and without a helping role in the face of such stark and profound disadvantage (Morris et al., Reference Morris, Mason, Bywaters, Featherstone, Daniel, Brady and Webb2018). These authors have described poverty as the ‘wallpaper of practice – too big to tackle and too familiar to notice’ (p. 370). In Australia, community-based approaches to child welfare that strengthen community and families are urgently needed. In Australia, Libesman (Reference Libesman2015) argues that a casework approach to child abuse and neglect responding primarily to incidents and reports has damaged the ability of Aboriginal and Torres Strait Islander families and communities to safely care for children. She argues for community strengthening responses that respond to social causes of child harm and rely on family and community involvement and leadership.

Most families with children in care have a lived experience of multiple social problems. A Family Inclusive practice approach takes account of the reality of family life including the social determinants of harm to children. It does not minimise the role of individual parenting skills and choices, but it does not restrict itself to them.

It is possible to address these issues in child welfare practice although it requires imagination and a willingness to learn from those most affected by social problems. I met with community workers at the Child Welfare Organising Project and other organisations in New York City doing organising, community strengthening and group work to support families in poverty (described in Tobis, Reference Tobis2013). The development of poverty aware practice guides, such as the anti-poverty practice framework for social work in Northern Ireland, is an example of how casework practice can, to some extent, respond to families in poverty in helpful ways (Morrison, McCartan, Davidson, & Bunting, Reference Morrison, McCartan, Davidson and Bunting2018). A willingness by practitioners and agencies to use agency resources to directly address material deprivation in families is a very useful place to start.

Peer parent advocates also play an important role in helping parents and families ask for practical help and resources to address the social barriers they face to care safely for their children. For some child welfare-involved families, the opportunity to be employed as a peer parent advocate is a pathway out of poverty and into paid work.

Element three – Including families in service design, implementation and management

As part of my Fellowship, I visited agencies and people implementing evidence-based and evidence-informed programs such as the Children and Residential Experiences model (Izzo et al., Reference Izzo, Smith, Holden, Norton-Barker, Nunno and Sellers2016), Mockingbird Family, (McDermid, Baker, Lawson, & Holmes, Reference McDermid, Baker, Lawson and Holmes2016), and Family Finding (Boel-Studt, & Landsman, Reference Boel-Studt and Landsman2017). All these implementers and others (Child Welfare Information Gateway, 2011; Hackworth et al., Reference Hackworth, Matthews, Westrupp, Nguyen, Phan, Scicluna and Nicholson2018) have emphasised the importance of family participation if their approaches and techniques are to be helpful to children and families.

However, the participation and involvement of families themselves in the design and implementation of services is often missing. Parent-led organisations in the USA such as Parents Anonymous®,Footnote ² a family strengthening program, and the parent-led consultancy, Authenticus LLC,Footnote ³ provide a range of consultancy services to child welfare agencies. Parent leaders in these organisations had lived experience of child welfare interventions, including child removal. They told me that child welfare agency leaders and staff tend to overestimate their skills and abilities in family engagement, including in the implementation of evidence-based programs. Agencies may feel that they are doing well because they have developed family engagement policies and processes, but how families experience these processes may not match agency expectations or beliefs. Family involvement in the design, development and implementation of these processes can allow for input and feedback from families and children, identify problems and generate ideas for innovation and improvement.

Parent-led organisations in the USA and Norway are working with universities and agency leaders to design, implement and evaluate innovative services (Summers, Duarte, Wood, & Bohannan, Reference Summers, Duarte, Wood and Bohannan2013; Slettebo, Reference Slettebo2013). Involving parents and families meaningfully in service design and implementation and reframing them as holders of unique expertise is an important part of building agency cultures that value and include families, with the potential to do Family Inclusive practice.

Element four – Ethical practice with people who are suffering

One of the reasons I became concerned with Family Inclusive practice in child welfare is because of the suffering I regularly observed by families and children caught up in child welfare systems, despite the best intentions of policy and practice and access to the best evidence. This prompted me to consider more deeply whether we are helpful, harmful or somewhere in between, from the perspective of those we are there to help. A narrow focus on evidence may be fundamentally flawed if it is not combined with an ethical lens, especially in child welfare where it remains so easy to do harm with the best of intentions.

Parent peer advocacy and connecting parents to each other through group work is an example of working to positively impact parents’ experiences and doing what parents and family find helpful. I visited a peer work program in the Bay area of California where an evaluation has found that parents who connect with a parent peer are more likely to reunify with their children (Berrick, Young, Cohen, & Anthony, Reference Berrick, Young, Cohen and Anthony2011). However, this emerging evidence is not the only justification for offering peer work. It is enough that parents and family, who are often experiencing great distress, value and appreciate the support of peers and find it helpful. Practitioners in Norway argued that families warranted support and involvement for their own sake. The Norwegian Ministry for Children and Family Affairs (2017) has funded a national parent’s interest group and argued that involving and helping parents and family was indeed good for children but also that:

Group processes that connect parents to each other are used extensively in Norway as a support service and have also been used to link stakeholders in child welfare together to learn from one another (Slettebo, Reference Slettebo2013). Practitioners working with parents and family in Norway were intentionally hospitable and welcoming in their practice. They carefully built reciprocal relationships and used kindness with parents in group work processes. In Norway, where parents with children in care get priority services from Bufetat, the universal Norwegian family counselling service, practitioners cooked and shared meals for and with parents with children in care. They ensured important dates such as children’s birthdays were remembered and celebrated. Their caring approach serves as a reminder that in our well-intentioned focus on ‘what works’ or what the rules and laws require of us, we should not overlook doing compassionate and kind things with people who are suffering.

In the UK, a review of the role of British social workers, with a focus on ethics in adoptions of children from care, has been conducted (Gupta & Featherstone, Reference Gupta and Featherstone2019). Most adoptions from care in the UK result in children effectively losing their birth families with little or no contact allowed (Neil, Cossar, Jones, Lorgelly, & Young, Reference Neil, Cossar, Jones, Lorgelly and Young2011). This review found that well-intentioned social work practice in child welfare adoption practice in the UK had a range of ethical challenges when considered from the perspective of adoptive families, birth families and adopted people. Birth families, in particular, talked about cruel and inhumane practices and a need to be both helped and treated with respect (Gupta & Featherstone, Reference Gupta and Featherstone2019). The review has highlighted the importance of listening to the voices of all stakeholders, especially those who are marginalised, and of social work practice characterised by humility, honesty and reflexivity. The review recommended that the British Association of Social Workers continue to focus on the ethical implications of adoption and the role of the social work profession, as well as on increased openness in adoption (Featherstone, Gupta, & Mills, Reference Featherstone, Gupta and Mills2018).

In Oregon, I visited an agency called Open Adoptions and Family Services (OAFS).Footnote ⁴ The OAFS team argued that current child welfare adoption practices in the USA were damaging for children and parents. Adoptions from care are common in the USA and are usually closed (Roberts, O’Brien, & Pecora, Reference Roberts, O’Brien and Pecora2017; Ryan et al., Reference Ryan, Harris, Brown, Houston, Livingston Smith and Howard2011). In comparison, OAFS works to implement a hospitable and welcoming approach (Gritter, Reference Gritter2009) to open adoption of children who face removal by child welfare authorities. Their approach relies on parental consent, relationships between birth and adoptive parents and an ongoing role for birth parents in children’s lives. The OAFS approach to openness welcomes and embraces children’s full identity, including their parent’s ongoing involvement in their lives which is supported by legally mandated adoption plans. Their approach encourages adoptive parents to empathise with birth parents and form child-focused relationships with them. OAFS provides free and lifelong counselling support to all birth parents to ensure children’s rights to know and have relationships with their birth families are upheld.

An ongoing role for parents and family in the lives of children in care is consistent with a children’s rights ethical framework. Australia has signed the UN Convention on the Rights of the Child (UN General Assembly, 1989), which links parent and family support, among other elements consistent with Family Inclusion, to children’s rights. I met with Professor Martin Guggenheim of New York University Law School, an expert on children’s rights and author of a landmark book on the topic (Guggenheim, Reference Guggenheim2005). He argues that to exclude family and to deny support and advocacy is unethical and at odds with the rights of children. Inclusion as an ethical issue is an important part of conceptualising and building Family Inclusive practice.

Element five – Conceptualising parents as leaders in their families and in the child welfare system

In Norway, parents have been reconceptualised as child welfare leaders in recent years thanks to the efforts of parents and key allies. They now have a national and funded peak body, the Organisasjon for Barnevernsforeldre (OBF),Footnote ⁵ which regularly provides advice to the Norwegian Government. Peer parent advocacy programs have a foothold in child welfare systems in many parts of the USA. These are actively promoted by the Federal Government because of their importance to good practice (e.g., Capacity Building Centre for the States, 2016). Parent advocates and other parent leaders in the USA are providing leadership in service design and in agency culture change. Conceptualising parents as leaders, both as parents of their children and in the broader system, is an important part of building a Family Inclusive approach.

For many programs and agencies, parent leadership inside teams and host agencies has emerged over time. Parent leaders I met during my Fellowship saw themselves as initially leading change in their own families and then becoming inspired to lead change in the child welfare sector. Their lived experience of successfully navigating the system led to them helping others and advocating for child welfare system improvements. Parent leaders used a range of techniques to provide leadership including role modelling, advocacy, negotiating and mentoring. Other groups, such as the Washington State Parent Advocacy Committee in the USA (Rise, 2019) and the Norwegian OBF, are undertaking system-level policy reform activities and are having a real impact on law reform and child welfare systemic reform. In Seattle, I met with a parent leader from the Washington State Parent Advocacy Committee who received a national award for her leadership role in child welfare in the USA (Casey Family Programs, 2018). Awards for parent leaders are an important way agencies can both identify and promote parent leadership.

The OBF regularly meets with the Minister for Families in Norway and is part of all major policy discussions in child welfare. In New York City, Tobis (Reference Tobis2013) attributes improvements in child welfare outcomes over a significant period of time, to the efforts of parent leaders and their allies.

The Family Inclusion movement in Australia is an important local example of parent and family leadership worthy of support. This movement is similar to parent leadership initiatives overseas in that parents, and their allies are working together to contribute to a better child welfare system. However, Family Inclusion organisations in Australia are resource poor and generally do not receive reliable funding (Ainsworth & Berger, Reference Ainsworth and Berger2014). Important leadership is also being shown by Aboriginal and Torres Strait Islander family organisations in Australia (e.g., Verass, Reference Verass2017). These organisations and movements represent significant opportunities to support parent, family and community-led change in the interests of children.

Element six – Relational permanence. Minimising children’s losses through carer and parent relationships and through the support and maintenance of relationships over time

Permanence is often conflated in policy and practice discourse with particular legal outcomes and court orders. This narrow focus conceptualises permanency as something that is achieved at a particular point in time – the day the court order is made. For example, New South Wales legislationFootnote ⁶ has specified a hierarchy, largely in the form of court orders that are seen to achieve permanency once they have been made. The language of children ‘waiting’ for permanence is used, suggesting that children’s development and their very childhood are somehow suspended in time until a court order is made. The implication of this discourse is that permanence is achieved by the court order itself and that when children do not return home, families who resist permanent legal orders are seen as barriers to permanency, rather than enablers through their ongoing relationship with their child.

This understanding of permanency excludes family and runs counter to the lived experience and needs of children. In reality, permanency is a feeling and a lived experience that happens over time and through attachments that endure. A court order may coincide with permanency, but it cannot achieve or create it when it does not already exist. Felt security or relational permanence for children in permanent care is improved when there is a strong sense of belonging to birth families as well as to the family with whom they live (Biehal, Reference Biehal2014; Boddy, Reference Boddy2013). Once we understand permanence as a relational experience that is important for all children and young people, it becomes clear that family relationships are integral to permanence. During my Fellowship, I explored examples of practice in which relational permanency was pursued. Both of the following examples involved respectful, child-focused and enduring relationships between alternate carers and family.

The first example is from Virginia in the USA where I met with practitioners, foster carers and parents who formed early and enduring carer and parent relationships during care and reunification processes as part of a program called Bridging the Gap.Footnote ⁷ Children were less likely to experience the loss of either their families or, after reunification, their carers, as the relationships between the adults in their lives endured. This quote from a mother whose child returned to her care summed up her child’s experience of relational permanency.

For this mother, a positive and enduring connection with the foster carer has ensured her child’s losses were minimised. He kept his relationship with his foster carer after being reunified with his family. Techniques and strategies from Bridging the Gap can be applied in any care setting, including kinship care, foster care and residential care. A co-parenthood model currently being trialled in Australia is another example of supporting carer and parent relationships to achieve reunification (The Australian Centre for Social Innovation, 2019).

The second example is from Open Adoption and Family Services (OAFS) in Oregon. OAFS challenges the idea that permanent care as a result of child welfare concerns means that parents have failed. The OAFS approach requires that birth parents facing permanent removal of their young children choose the adoptive parents of their child from a selection of pre-approved adoptive parents. They make this choice through reading adoptive assessment material and in discussion with the OAFS team. Prospective adoptive parents are required to be willing and able to support ongoing birth family involvement in children’s lives. All birth parents can access free, lifetime post adoption counselling and support services from OAFS. While OAFS practice is concerned with open adoption in the USA, their approach has implications for any kind of permanent care arrangement including arrangements in all Australian jurisdictions.

Both of these examples emphasise the development of natural and enduring relationships between birth family and alternate families as a pathway to permanence regardless of the case plan goal or legal order. Importantly, neither of these examples required foster carers or adoptive parents to supervise children’s time with their families, as this would have contributed to power imbalances and potentially damaged relationships between carers and parents. The role of the carer was relational, reciprocal, inclusive of family and child focused. Supervision and evidence gathering, if it was needed, came from elsewhere.