Paper
Development and experimentation of a programme, Family Project, for neglectful families: Lessons from research and practice
- issue: Issue 1 / 2009
- authors: Michèle Brousseau, Madeleine Beaudry, Marie Simard
- keywords: family, therapy, Canada
- views: 5074
- downloaded: 0
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abstract
Background. Neglectful families represent a challenge for child welfare and child protection services. Until recently, research on family functioning and on child neglect have remained separate fields, although recent researches have identified family functioning problems (Gaudin & Dubowitz, 1997; Brousseau, 2000) that could be harmful to the security and development of children. From the point of view of family functioning theories, neglect can be defined as an inhability of the family to carry out essential functions such as protection and socialization of children. Studies also indicate that services, including family therapies, generate modest positive changes and «that we have to find out what works and what does not, with whom, and in what situations» (Dufour & Chamberland 2004). The Family Project was designed for seeking effective strategies for high resource-using youth and families.
The objective of this innovative approach was to develop an ecosystemic family therapy programme, with a focus on family functioning (Ryan & al., 2005), for neglectful families. The McMaster model of family therapy is a four steps model: evaluation, contract, treatment and end. The model focus on a comprehensive evaluation, an active collaboration of family members and on the strengths of the family. Two assumptions are underlying the development of this programme. The first is that ecosystemic, behavioural and cognitive theories of family functioning contribute to reduce neglectful behaviours. The second is that researchers and practitioners should cooperate to develop programmes and interventions on scientific basis, whose objectives and strategies are clearly defined and that can be implemented and evaluated in field practice.
Method. The action-research design involved social workers (N = 4) in youth protection and front line services in Quebec (Canada) and included an experimentation of the model of intervention in order to evaluate its feasibility. Prior to the experimentation, social workers received training in family therapy. Supervision was also provided to them throughout the process by the research team. The sample included neglectful families (N = 12). Analysis were based on qualitative and quantitative data (self-report and observational). The questionnaires included family functioning measures, social support, individual and family problems, and depression. Parents answered the Family Assessment Device (FAD) (Epstein & al., 1983) and other measures before and after intervention. Social workers filled the McMaster Clinical Rating Scale (Mcrs) (Miller & al., 1994) after the evaluation of the family and at the end of the intervention; they also kept a notebook of their interventions and observations through all the intervention process.
Key findings. According to the degree of implementation of the model and to family, results indicate different effects. Some families showed improvement in their family functioning although no changes were observed for others. The families who showed improvement were the ones whose members all participate to family meetings and all the steps of the model were followed. These cases were closed, except one where a long term occasional support was needed. Some other families stopped the family therapy after the evaluation process and they did not engaged in treatment. The voluntary clients chose another form of treatment and, in another family, the child had to go back in foster care, but the evaluation done with the whole reconstituted family help to clarify a permanent plan for the child. Last, some family showed no improvement and persistent problems. In these cases, the families did not get involved in family therapy, even if they were voluntary to participate in the research project, and social workers go back to the usual individual intervention with only one family member.
Different family structures (single-parent, intact, blended) raised questions on how this model should be applied and the research team chose to have an inclusive definition of the family. The Family Project has allowed the development of a family therapy model with an ecosystemic framework, the clarification of the conditions of eligibility for families and the identification of the organizational issues for further implementation (e.g. training and supervision). Also, it has had an impact on the practices of the social workers, like a «paradigm shift». This would not have been possible without a direct experimentation of the model and the collaboration of practitioners and researchers.
According to the experimentation, family therapy should appear as one specific tool for helping neglectful families. Keeping in mind that social workers were simultaneously trained as they worked with families and that the model had been experimented with a small number of families, findings point out promising intervention for improving family functioning and reducing neglect and the necessity for further experimentation and evaluation research in family therapy with neglectful families for a better understanding of the utility and limits of this approach with different family realities.
For programme development, qualitative observations suggest that the process followed appears as an important preliminary step for designing evaluable programmes with solid theoretical basis and adapted to field realities. Moreover, the use of standardized tools for evaluation has contributed to improve the social workers' clinical judgement, to give systematic feedback to families on their functioning and to elaborate hypothesis in order to explain the discrepancies between results obtained from parents and social workers on some dimensions of family functioning.
Key references
Brousseau, M. (2000). La perception du fonctionnement familial de parents négligents et non négligents et les facteurs familiaux, parentaux et environnementaux associés. Thèse de doctorat. Québec: Laboratoire de recherche, École de service social, Université Laval, 158 p.
Dufour, S. & Chamberland, C. (2004) The effectiveness of selected interventions for previous maltreatment: enhancing the well-being of children who live at home. Child an Family Social Work, 9, 39-56.
Epstein, N.B., Baldwin, L.W. & Bishop, D.S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9 (2), 171-180.
Gaudin, J.M., Dubowitz. H. (1997) Family Functioning in neglectful families: Recent research. In Child Welfare Research Review, Vol. 2 (eds. J.D. Berrick, R.P. Barth & N. Gilbert), pp. 28-62.
Miller, I.W., Kabacoff, R.I., Epstein, N.B., Bishop, D.S. Keitner, G.I, Basldwin, L.M. &. van der Spuy, H.I.J (1994). The development of a clinical rating scale for the McMaster model of family functioning. Family Process, 33, 53-69.
Ryan, C.E., N.B. Epstein, G.I. Keitner, I.W. Miller & D.S. Bishop (2005) Evaluating and Treating Families: The McMaster Approach. Routledge, New York & Hove.
Contatti: Michèle Brousseau, Centre jeunesse de Québec - Institut universitaire & Université Laval, 2915, avenue du Bourg-Royal, Québec (Qc), CANADA, 1-418-661-7291, poste 1721, E-mail:Michele_Brousseau@ssss.gouv.qc.ca.