Introduction
Keeping children safe is the core function of child and family practice, and safety is enhanced by the development of sustainable, nurturing parenting. Family Preservation (FP) programmes are located at the tertiary end of the service continuum, providing parents with an intensive intervention designed to keep children safely at home and prevent placement in out-of-home-care. The researchers' interest is how parents who have participated in FP programmes define and describe their experiences, and how this impacts on outcomes. The aim was to add to knowledge of what it is about these programmes that leads to positive outcomes.
Family Preservation
The first of the many variations of family preservation programmes to emerge over the past four decades was the Homebuilders® model. Developed in the USA (Kinney, Madsen, Fleming, & Haapala, Reference Kinney, Madsen, Fleming and Haapala1977) it was specifically designed to prevent the placement of children into out-of-home-care. The Homebuilders model was developed at a time when there was increasing recognition that removing children from their families had a significant cost ‘. . . in terms of loss, trauma, stigmatisation and identity problems’ (Corcoran, Reference Corcoran2000, p. 76). Core programme components included an immediate response to referrals (contact with the referred family occurs within 24 hours); worker caseloads of only two families at any one time; flexibly delivered service in response to client needs (client–worker contact could occur outside business hours); brief service (4–6 weeks), intensive service (up to 20 hours per week) and access to afterhours support (National Family Preservation Network, 2012). The Homebuilders programme provided a framework for the development of family preservation programmes which were introduced into Victoria, Australia, in the early 1990s. These programmes, funded by the Department of Human Services and delivered by the community sector, also had a placement-prevention focus. The programmes were specifically designed to support families at the point when placement of children was considered imminent. The combination of the strengths-based approach to practice, which underpins FP programmes, and its embedded service principles ‘to instil hope’ and that ‘troubled families can change’ (Kelly, Reference Kelly1995, p. 8), have an unequivocally optimistic flavour to them, exhorting workers to bring a sense of hope and agency to families.
Despite an espoused belief that families play a key role in the FP partnership, the not inconsiderable body of FP research has not given commensurate attention to researching what participating in FP programmes means to them. More than two decades ago, Pecora, Fraser, Bennett and Haapala (Reference Pecora, Fraser, Bennett, Haapala, Fraser, Pecora and Haapala1991) stated that seeking the client's perspective is important to understanding the effectiveness of the programme. They attributed the lack of research into the client's experience of FP programmes at that point to the field being young and the focus being on implementing new programmes while maintaining current programmes. Drisko (Reference Drisko1998), 7 years later, suggested that the client perspective was still not being heard strongly in FP research, despite client feedback being a key platform of the FP approach. Walton and Dodini (Reference Walton and Dodini1999) concurred, stating that, of the diverse range of research projects that have looked at outcomes for FP programmes across a range of variables, researchers have ‘frequently failed to listen to the opinions of the consumers’ (p. 40).
Cortis (Reference Cortis2004) suggests that service providers often find evaluation activities ‘too disruptive, complex, imposed, irrelevant, [and] time consuming’ (p. 1). Another reason why evaluations may not have considered clients’ experiences of programmes is the difficulty in recruiting this vulnerable cohort in evaluations. The difficulty in recruiting clients is noted by Duerr Berrick (Reference Duerr Berrick2008), who suggests that ‘. . . agencies often have an inclination to be protective of their clients. Researchers asking for direct contact with clients can face a number of bureaucratic obstacles’ (p. 119).
Importance of Hearing the Story
The voice of the parent has been ‘faintly heard in the field of child welfare research’ according to Duerr Berrick (Reference Duerr Berrick2008, p. 118), who suggests that the inclusion of the parents’ perspective has been the ‘exception more than the rule’. This has created a gap in understanding how programmes support the families with whom they work, despite their experience being influential in determining the outcomes achieved. Although there has been some progress over the past decade in including the ‘client voice’, child welfare clients have not developed into a self-advocacy movement (Meagher, Reference Meagher2002, p. 1). The stigma and sense of blame experienced by families in child protection systems is likely to contribute to families wanting to maintain anonymity in the community. As suggested by Kapp and Vela (Reference Kapp and Vela2004, p. 198), ‘the stigma of having had one's children removed and cared for by someone else may be a contributing factor to overlooking solicitation of parents’ opinions’. Forty years earlier, Tierney (Reference Tierney1963) suggested that this lack of active engagement with parents in the child protection system reduced the parental role in child welfare ‘to a mere insistence upon legal rights and responsibilities’ (p. 13).
Consulting with parents in the child welfare system about their experience of services has the potential to be an empowering experience if they are engaged in an authentic manner in which the agenda is made explicit, as is the influence their participation can achieve. This process recognises that those who experience a service are best positioned to know what works for them. Until recently, feedback has not been sought as a matter of course in the child and family welfare field, and its emergence has been due more to the need for fiscal accountability than a response to consumer lobbying.
This study's significance is in giving voice to ‘disenfranchised stakeholders’ (Cortis, Reference Cortis2004, p. 2). Knowing how parents experience the interventions designed to assist them develop better parenting adds to knowledge of what works and why in these programmes.
Role of Self-esteem
Self-esteem can be understood to reflect both the internal value the individual places on themselves, as well as how they understand their value in relation to others around them. Mruk (Reference Mruk2006) suggests that self-esteem ‘has to do with an abiding sense of self-worthiness as a person or the experience of being able to solve problems competently or both, self-esteem is intensely personal in part because it says something about how we are, how we live our lives’ (p. 3). This study, an exploration of parental self-esteem, was underpinned by the assumption that long-term involvement with child protection services would negate a positive sense of self as a parent, thus negatively influencing parents’ capacities to change and provide well for their children.
The Current Study
As there has been limited research into parents’ experiences of participating in FP programmes, an exploratory approach was employed. The study explored how parents receiving a Family Preservation intervention experienced participation in the programme. The initial research design utilised a pre-intervention/post-intervention approach. This was to facilitate exploration of parents’ sense of self-esteem as a parent at the beginning of the programme and then to invite them to reflect upon changes in respect of their sense of self as parents at the end of the programme. This design could not be implemented as organisations delivering the programme considered that providing a researcher with access to parents at the time they commenced the programme would impact negatively on the parents’ engagement in the programme. This highlights the challenge in researching parents’ experiences in the child welfare field and the lack of agency these parents have in deciding themselves whether they want to participate in studies. This led subsequently to a change in design, with in-depth interviews being conducted with parents as they concluded their involvement with the FP programme.
Although there was some enthusiasm at first for the research from all the organisations approached, this did not translate into preparedness to participate, and in the end only two organisations agreed to be part of the study. The challenge of recruiting parents to participate paralleled the challenges experienced in gaining organisations’ approval. The researcher was dependent upon programme workers discussing the research project with their clients to enlist participation. Given the challenges facing families at this time, participation in a research project was unlikely to figure highly.
The study was guided by phenomenological theory, with its focus upon exploring ‘. . . situations in the everyday world from the viewpoint of the experiencing person’ (Becker, Reference Becker1992, p. 7 cited by Liamputtong & Ezzy, Reference Liamputtong and Ezzy2005, p. 18). It provides the framework for the researcher to understand the life world from the perspective of the client. The focus here is on the meaning the parent attributes to the experience of participating in an FP programme.
Five families were recruited successfully to participate in the research from two community service organisations that delivered FP programmes in metropolitan Melbourne. One of the organisations delivered an intensive FP programme, while the other delivered an intensive, yet longer-term programme. The two organisations that agreed to participate in the study assumed responsibility for informing parents about the study. If parents expressed interest, the researcher could either contact them directly or organise to meet with them through their FP programme worker. All of the parents who participated in the study had been referred to the respective FP programme via Child Protection. Four families had long histories with child welfare services, including, for two families, the previous removal of their children and long-term placement in out-of-home-care. There were four sole mother-headed families and one sole father-headed family and a total of 12 children. The interviews conducted with parents focused upon their experiences of past services, their experience of FP programmes, and how they viewed themselves as parents, both before FP intervention and at the time when they closed with the FP programme.
Denzin and Lincoln (Reference Denzin and Lincoln2003) assert that ‘validity in qualitative research has to do with description and explanation and whether or not the explanation fits the description . . . the description of persons, places and events (being) the cornerstone of qualitative research’ (p. 69). The interviews (except one) were all taped to enable more accurate transcribing. The data were initially written up as responses to the questions, and then the collective responses were analysed to determine if there were any shared themes, which were then categorised and further interrogated. The interpretations were then reviewed against the direct quotes from participants to determine if these interpretations were supported by the data.
Approval for the study was obtained from La Trobe University, the Department of Human Services and the ethics committee of one of the participating organisations.
Findings
The findings are presented to highlight the major themes that arose from the analysis of the interviews. Pseudonyms were given to each participant, and other identifying data have been removed. The themes are first identified and are supported by quotes from parents. These quotes are important to ensure that the voices of the parents are heard.
The interviews were analysed identifying each parent's ideas individually around the key research concepts – parental self-esteem, experience of family preservation services, previous experiences with non-FP services and the impact of FP services on parental self-esteem. Then all of the participants' answers to specific questions were collated to explore for any commonalities. The next stage was to group these commonalities into themes, which are presented and discussed below.
Hope
The promotion of hope is fundamental to FP practice and a key worker task is that of ‘instilling hope’. The respondents in this study identified a sense of ‘hope’ that emanated from their participation in the programme. Parents commented that they could now see a better future for themselves and their families, with an accompanying sense of optimism. They considered that workers demonstrated hope in them as well, in the way they spoke to them, encouraged them, congratulated them and celebrated them. Hope offered participants a glimpse of how they could be in the future, as articulated by Holly when reflecting on her involvement with FP: “I tried to end my life too but now I know I will take care of my kids, I would never want to give up.” Holly's journey had embraced the depths of despair, having attempted suicide; but had come to believe that she and her children could have a good life together, describing herself after being involved with the programme as,
“more confident, much more able to manage on my own – never thought I could do things alone – I am much more capable of doing by myself – have to be self-dependent. [I] believe in a future with my children, have goals for them to be good people who will do well”.
For Holly, her FP workers had “shown my strengths, unless you are told, you are not sure what you are capable of – [the worker] tried to get strengths out of me – she would write them down for me”. For workers to simply suggest that a client has strengths is not enough, because as Holly states, “unless you are told, you are not sure what you are capable of”. For Fleur, whose involvement with statutory services had commenced in her youth, engaging with a FP programme differed from her experience of other services. Fleur said that being able to talk openly with her worker was critical and she could talk easily to hers, finding her to be non-judgemental, bringing with her a sense of hope, (she)
“Definitely brought hope with her . . . oh yeah strong.”
Hope supported Fleur to strengthen her resolve that she could again parent her children and become “human now like a mum”.
George's vision of his family's future was underpinned by a belief that life could be better for his family, stating that “I have the ideas to do better for my kids.” For Irene, a sense of hope was especially important as she had approached the idea of working with FP with a sense of foreboding, stating that she feared “something bad will happen and I will be a failure”. Of the five participants, Irene expressed the greatest sense of anxiety about her future at the commencement of service, with comments such as “it feels like darkness”. For Irene hope was found in meeting her goals, and FP had “helped us meet what we needed to meet”. June differed from the other participants in that she presented as having some sense of optimism and hope from the time she was referred to FP. The sense of hope was evident in June's avowed belief in the longevity of the changes she had instigated in her life during the four weeks working with the brief FP programme. She stated that, unlike her work with other services, this time:
“I am in the process of taking it further so it won't revert back.”
Hope plays a pivotal role in any change programme, it supports the belief that things can get better and that life can be different. The respondents identified that they had hope in their futures, which had grown not just through their capacity to meet their goals, but also through the relationships they had experienced with their workers. The workers did ‘instil hope’; they supported the families to find their strengths and encouraged, supported and worked alongside them. This was presented as ‘new information’ by the respondents, whose lives had been so inextricably tied up with support services that they had lost a sense of agency in their own lives.
Experience of Services
It was anticipated that FP consumers would have had considerable experience with a range of support services, including Child Protection, prior to engagement with FP, and that they would describe these services differently to how they described their experience with FP. All but one participant had a long involvement with child welfare services, including Child Protection. Each participant was asked about their reaction to being referred to FP, and their responses contrasted markedly to the optimism expressed by participants post service. The response from four out of the five participants was cautious at best, to overtly hostile. The one participant (Holly) who did not have any service history other than with Child Protection was very cautious as to what to expect from the programme. The only male participant (George) had considerable experience with services, including mental health services, and he had concluded that “all services are crap”, making explicit his disdain. George stated that Child Protection had referred him to a mental health service and he had attended a psychiatrist ten times and “we sat looking at each other”, commenting that he felt the psychiatrist was “going to bury [me]”. This seemed to reflect concern that the psychiatrist would write a hostile report that would not support reunification with his children. This respondent felt very strongly that Child Protection had referred him to FP not to support him, but to find him wanting:
“child protection did not want me to get my children – got FP involved, [workers] go under different names but all the same workers . . . he's [FP worker] been good looking at it properly”.
Another participant, when told she was being referred to a FP programme, commented that she
“thought it would be a pain in the bum . . . had a lot of workers from support services but they didn't help, I had expected help but they didn't so I thought another one so I will see when the worker comes” (Fleur).
This participant had previously been involved with a number of services, including housing programmes, family support services and Child Protection, stating that she could not recall all the services with which she had been involved over the years, the inference being that there were too many to mention. This participant spoke of the untrustworthiness of workers and why she was initially apprehensive about becoming involved with FP. Subsequently, Fleur had few expectations of FP based on her experience of support in the past.
The only respondent (Holly) who had been involved with one service previously (Child Protection) commented that Child Protection was child-focused, and she felt this was not enough as parents needed support too, commenting insightfully that, “parents if looked after [are] better with children”. This looking-after meant recognising and understanding her needs and the challenges she faced as a sole parent and as an immigrant.
One respondent with a long involvement with child welfare services, including as a child, commented that being referred to an FP programme made her feel:
“a negative thing that can destroy everything as I feel something wrong and something bad is going to happen”.
Another respondent (June) had experienced a range of support services, including mental health and family support, and expressed some ambivalence about past services overall, commenting that “FP gave me results [within four weeks] whereas [mental health service], 12 months and no results”. This respondent's sense was that FP had provided a more robust intervention that delivered a way forward for her and her daughter, measuring the outcomes via the results that had been achieved.
Consumer–Worker Relationship
Themes identified under the heading of the ‘consumer--worker relationship’ are discussed here.
Agents of control
Participants were aware of their vulnerability to the influence of workers in respect of decision making. George categorised all workers as ‘agents’, stating that although workers may operate under different guises, all are part of the conspiracy “to catch families out”. This had very clearly been George's experience and it was not until he met his current FP worker that he experienced an alternative view of support services. Fleur did not name her FP worker as an agent but she did refer to being ‘watched’ commenting that workers, “watch you and see what support you needed”. Fleur was not being critical of FP as such, but her long-term involvement with Child Protection and services had made her very aware that she was watched and assessed, and took this for granted. Her reflections were based very much on tangible observations, whereas George seemed more able to identify the subtleties of language and demeanour of those around him.
Consumer–worker partnership
The notion of a partnership between the FP worker and family was a strong theme in parents’ responses. George's recognition of his FP worker as an agent did not preclude him from viewing his relationship with his FP worker as a partnership, describing him as, “a pleasant person, helped, older person who can give me ideas – used his experience and my methods – good working with him”. For George, who had felt “oppressed” by other service approaches, it was a liberating development to feel that he was being listened to. Not “buried”, as he had described earlier feelings when meeting with a Child Protection appointed psychiatrist. In respect of his FP worker, George commented that he was “like a saviour – came to school with me – came most days, kids like him”. This is a powerful analogy, a description of a messianic figure who supported George and his children, in contrast to previous ‘experts’ with whom he could not establish a trusting relationship.
For Holly, the referral to FP was worrying as she had no framework by which to consider what the referral would mean, having only been involved previously with Child Protection. Holly commented that she “was feeling a bit nervous as I was not sure what type of people I was going to meet-you do not want to tell your story again to new people but best thing was I only ever had to speak to H1 and H2 [workers] – becoming like a family, they knew so much about you, it builds up a rapport which you do not want to break. From start to end, me and my kids only had to relate to H1 and H2. H1 was so beautiful to my kids”.
Holly's comment that her workers had assumed a familial role identified the importance of the service in her life and that of her children. It also supports the idea that families involved with support services often have very limited social support networks, and this privileges the role of the support adult in their lives. Through her engagement with the programme, Holly considered that she was now
“more confident, much more able to manage on my own, never thought I could do things alone, used to think that if my husband left me, I would be dead, I won't survive, feel from inside that even if he is not around, I am much more capable of doing by myself, have to be self-dependent”.
Holly had begun to view herself differently as a person, not just as a parent; describing herself now as “independent, confident and optimistic”. Although Holly did not mention ‘empowerment’, she had been empowered by participation in the FP programme, which liberated her from oppressive thoughts and expectations.
Consumers’ perception of the value of FP
June suggested that one of the strengths of FP was that it “gave me results”. Over the previous decade, June and her adolescent daughter had been involved with many services, none of which had proven effective in sustaining change. Distinguishing FP from her earlier involvement with another family support service, which offered less intensive interventions, June felt the latter had more of a counselling focus, whereas FP was focused on parenting. She suggested that the “FP style would have been more helpful back then”. In respect of the services that the FP programme provided, June replied “parenting skills, one to one dealing with family crises”. June commented that participation in the FP programme had given her “new ways of working with [her] daughter without anger – M. [CSO1 worker] gave me practical advice, helped me take it on”. June considered that, despite the brevity of the service model, the changes she had experienced would enable her to “take it further this time so will not revert back, help me take things on quicker – would recommend it to other families”.
Irene considered FP workers “to be very honest”. Fleur spoke of her workers’ “real help and fight . . . to get me to do things. M. [worker] kept the fight up”. Fleur felt that the worker was very much in her corner, supporting her to achieve the results she wanted. Being “in it together” was how the participants depicted their engagement with the FP programme. Irene described her worker as someone who would, “give a hand, they talk, good friend you can bounce ideas off, [do] things different”. In respect of the services that the intensive FP could provide, Fleur commented that the worker could
“watch you and see what support you needed and help figure out what I need help with, having someone here a few times per week was better, gave ideas, B. [her son] had been diagnosed with ADHD and I was going mad and I knew I needed help as they had challenging behaviours, intensive determined to try anything to make it work”.
She felt that her worker had “tried to teach me different strategies on how to work with kids’ different behaviours”.
Parental Self-worth
The participants tended to express positive descriptors about themselves as parents. George stated that he was working with FP, “doing for my kids, I love my kids, having a responsible partner would be good but not to be . . . understand what I am doing from day to day, they’ll know Dad is doing the best I can, good education, money, sports, keep them out of trouble”.
Holly identified a very clear shift in how she described herself, but less so in how she viewed herself as a parent, believing she had always been a “good mother”. The change Holly identified was how she viewed herself in relation to her strengths and competencies as a person. Holly reiterated several times that she was much more “confident, independent”; two descriptors identifying a significant change in her sense of self. Holly also identified how others now saw her, commenting that people were “noticing” differences with her – “many people notice me, they say I look different now, my personality, everything, always had it but [FP worker] brought it out”.
Similar comments were made by Fleur, who stated that:
“I love it when people say I am different now . . . what does it mean for the future . . . we have a future to have our family, anything we want . . . a proper family, a family, a big thing with Dad come for dinner and we all sit at the table and sit together . . . I never really had a family.”
What Fleur wanted for her children was a “proper family”, which she described as everyone knowing they are “loved and cared for”. Fleur was challenged occasionally when one of the children would make the comment that she “didn't care about them” to which she would reply,
“Yes I do, that is what I do sometimes, and I snap and say you are lucky to have mummy and daddy as I never did. I tell them some of the things I have gone through and I have made a lovely home [for them].”
When asked if others had noticed any change in her, Fleur commented that family and friends suggested that she looked “more human [now], when I didn't have them [children], I was off my head . . . I used to hide inside and now I say get me out . . . they say I am like my mum, now I am bubbly and people tell me to shut up, whereas [I] used to be quiet and withdrawn, got my Ls [learning to drive permit]”. The affirmation of others was very powerful for Fleur, who had experienced the censure of others (upon having her children removed). In describing herself as a parent, Irene commented,
“I love my kids and would do everything for them, I am true to them I don't need to be able to trust them – I have had my own issues, I have been true to that – most a parent can do but I would like to be a better provider but as a child I knew that if your child does not have confidence they do not have the chance to get what they want in life”.
Irene did consider, however, that her sense of self as a parent had changed through working with an intensive FP, stating, “yes I am happier – it is not all about you . . . but it is all about you . . . as it is all about me so that I am better for them now – and happier for myself”.
The final quote comes from Irene, who summed up her experience of FP, as a programme that
“reinforce(s) positive things and help[s] us to meet what we needed to meet . . . felt like alive but that lift was helpful. I think I’ve got to remember that what I do right and keep reinforcing what we can [do] as a family . . . am learning to be prouder”.
Conclusion
The notion of hope was identified in each of the parents’ responses. Hope was evident in their commentaries about their newly realised potential for a better future for themselves and their families. They attributed hope in a better future to the way their workers engaged with them. This appeared to be new territory for the participants, to be alongside people who had hope in them and for them. The FP workers demonstrated their hope for families in the way they spoke to them, encouraged them, congratulated them and celebrated them. These were clearly new experiences, noted even by the only male participant, who presented as very service-weary. As Scott (Reference Scott2006), writing about families in the Child Protection system, states, ‘the children and families with whom we work have often lost hope as have the communities in which they live’ (p. 19).
This study highlights the role that hope plays in generating change, and how this hope brings with it a more positive sense of self as a parent, as well as new skills. Practitioners were able to facilitate engagement with families for whom there had been multiple interventions, from both the statutory and community sectors, and which parents had often constructed as unhelpful. Parents were clear about the strengths of the FP approach, with its focus on building respectful, collegial relationships that affirmed them and enabled them to construct a new, more positive and productive story that would support their families.
The hope described here is one that could harness strengths and capacities, and recognise the parents’ innate worth. The challenge is in the sustainability of the changes in the long term. Each of the parents interviewed for this study, who had participated in a short-term FP programme, was referred on to a longer-term family service, to assist them to consolidate the changes. They were engaging with these services with a sense of hope and an increased sense of worth as parents. The consumer who participated in a 12-month FP programme was ready to terminate her involvement with services, feeling that she was ready to harness her own capacities to care for her family independently.
For the parents who participated in this study, the family preservation experience was perceived as empowering and hope-giving. They identified what they found to be helpful, which is knowledge that can be used to inform practice and contribute to increased understanding of what works for vulnerable families. This adds to the evidence that ‘troubled families can change’ (National Family Preservation Network, n.d.). It also draws attention to a consideration of how practice can be constructed as hope-giving. How do we bring into our work a sense of hope? What is it in our practice approach that can be discerned by our clients as hope-giving? What would our clients report about our approach that would be interpreted as demonstrating hope in their capacity to change? The importance of hope is captured well by the philosopher Grayling (Reference Grayling2008), who wrote:
. . . although hope by its nature is a forward-looking emotion, its real effect lies in the present: it is what motivates and encourages now, it is what makes a difference to how the world seems to us even in the middle of difficulties. (para. 10)
Essentially, it is the message of hopefulness that practitioners need to bring to their work, in the midst of difficulties, which can make a real difference.
