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Paper

A local service for children and their families: resulats of four years of activity

abstract

Background. Since 2003, the Centro per il bambino maltrattato e la cura della crisi famigliare (CBM, Centre for Abused Children and for the Treatment of Families in Crisis), in close collaboration with the town councils of Rozzano area (district of Milan), has run a service for families and their children. This followed the decision by the district to revoke the task previously assigned to the local Health Department (called Asl in Italy). The main reasons for this decision were:

  • the long length of the placements of the children who had been removed from their families and placed in residential care, with subsequent substantial costs for the authorities, and with very little sharing of the reasons for the placements or possibility of controlling the costs,
  • lack of easily available contact points for the network of agencies that normally deal with children (typically schools, but also the churches, day centres etc), and families needing advice or consultation on how to deal with crisis situations and problems involving their children, both children already receiving social services, as well as those possibly at risk or about whom there were simply concerns,
  • lack of services located near to families where they could go for help with problems connected with parenting particularly at critical phases in the family life cycle. The local community regarded the service as one that existed only  "to remove children from their parents", and one that often failed to address welfare and secondary prevention.

The mission of the new agency was to alleviate these criticisms and build a service dedicated to the welfare of children and their families, close to the community and capable of linking prevention and treatment.

The CBM had proposed a project drawing on knowledge built on years of work with children and abusing families, and on knowledge of possible risk, that at the same time used the protective factors that could be enhanced by close working  with the local community. Professionals working in the Servizio per la Famiglia e i minori (SFM Service for Families and Children) are locally based social workers and 10 psychologists connected with CBM. The district is composed of 4 municipalities (80.000 inhabitants) with a local team in each. A centralized team focuses on the evaluation and treatment of families with children placed in care in the most severe cases of abuse, following a court order.

The implementation of the new service for families and children has been accompanied by other changes in the system: communication strategies, a handbook with guidelines, a coordination board (with representation of  CBM and the local authorities), ongoing supervision for the various teams; an information and documentation system for the collection of data on the activities and characteristics of the service. From the beginning, some simple sets of data have been regularly collected every six months in order to monitor progress.

Findings. After little more than four years it is possible to evaluate the first impact of this new service for families and their children, in particular the number of children in residential and foster care and the different agencies and people making referrals to the service.  The following points should be noted:

  • after an initial increase, a significant reduction in the number of children placed in residential care, from 55 children  placed in 2002 to 39 in 2005. The increase in placements in 2004 (65 children) shows that the SFM (Servizio per la Famiglia e i Minori) has been able firstly to extend protection and then to reduce the time and the numbers of children in residential care,
  • a relevant increase of contacts between the SFM and local agencies, especially schools,
  • an increase in the number of people spontaneously referring themselves to the SFM for help in violence or severe crisis in families with children.

The data shows us that requests from the judicial authority have reduced from 63% in the first year to 52% in the third year; the requests from the community network have increased from 15% to 23%; and self referrals from 15% to 28%.  These figures support the decisions on which the service is now based.

  • the decision to localise: this has brought the service nearer to the families, building 4 local teams,
  • giving the service responsibility for intervening in various contexts, maintaining continuity between the service and the family, including in situations of court intervention, linking the help within a framework of prevention and repair to damage, through two linked levels of intervention,
  • attention to the training of teachers and to availability of guidance in critical situations, such as the participation  of the local teams of workers in organising evenings around themes focussing on parenting.

There is increasing evidence from the local areas that the service is now seen, both by schools and by families, as one that is close to those most in need,. This suggests the service is tapping into the needs of parents in difficulty, and who need  guidance that is not about economic and material matters. Secondly it suggests a partial change in the image of the service, from that of a service that is at a distance, one that should be feared, and one that "takes away children", to one that is close by and  that is there to help parents and children. Other successful factors to note are:

  • the stability of the workers and the low turn-over of staff (the users benefitting from the continuity),
  • the care taken to maintain the complex vision of the system through the means of periodic evaluation involving various levels: practitioners, those responsible for services, the project and for coordination,
  • shared training courses,
  • an information campaign.

Contacts: Teresa Bertotti, CBM - Centro per il bambino maltrattato e la cura della crisi famigliare, Via Calatafimi, 10 - 20122 Milano (I), E-mail: teresa.bertotti@cbm-milano.it, Phone+ 39 02 66201076/+ 39 333 5995813.

 

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