Running head: PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 1 Providing Effective Family Support Services to At Risk Families: A Manual for Family Resource Centers Sandra Gay Koenig A Thesis Submitted to the Department of Education California State University Bakersfield In Partial Fulfillment for the Degree of Masters of Education Winter 2012 Copyright By Sandra Gay Koenig 2012 CERTIFICATION OF APPROVAL PROVIDING EFFECTIVE FAMILY SUPPORT SERVICES TO AT RISK FAMILIES: A MANUAL FOR FAMILY RECOURCE CENTERS By Sandy Koenig c?~~~a~.._ .7-;/-1 ].__ CaryL-M~h.D.? Date Committee Chair 7-1;-1 2- Irene Cook Date 7-/~-/J.-. Kathy Philley Date PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES TO AT 2 Abstract This project will provide an in-depth review of research literature regarding prevention of child abuse and neglect through family support services provided Family Resource Centers. Included is a brief history of child maltreatment and prevention efforts in the U.S., recent child abuse and neglect data, key terms used in the child abuse prevention field, and risk factors that contribute to the incidence of child maltreatment. Core components of Family Resource Centers, with an emphasis on services and activities provided by Kern County Family Resource Centers, will be described as well as selected evidence-based and evidence-informed parent education and home visitation programs currently in use. Core services include parent education, home visitation/case management, school readiness, and "safety net" services for at risk families. The purpose of the project is to create a format for a standardized Family Resource Center Manual that includes a description of core services, effective program characteristics and strategies, and evaluation methods used to implement successful family support programs. The information is designed to provide a frame of reference that can be customized to the needs of individual programs. PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 3 Providing Effective Family Support Services to At Risk Families: A Manual for Family Resource Centers Davidson wrote (1977) “The overall health of a society can be determined by the manner in which it cares for, protects, or abuses its children.” Throughout history child abuse, including severe corporal punishment, sexual abuse, and even infanticide, have been an integral, even accepted, part of various societies and cultures. In the U.S. patriarchal hierarchies and puritan attitudes of “spare the rod, spoil the child” dominated child rearing. Children were considered property, thus parents as their “owners” were given unrestricted authority to do to a child whatever they deemed necessary. The first reported case of child abuse in America was made to the American Society for the Prevention of Cruelty to Animals on the grounds that children could be classified as animals and thereby protected to the same extent as an animal. This case led to the formation of the New York Society for Prevention of Cruelty to Children in 1875, the first child protective agency in the world (Myers, 2006). Historically, child abuse was not recognized within the medical profession in the U.S. until the late 1940’s, when Dr. John Caffey, who established the first pediatric radiology department in America, identified and began to report in pediatric radiologic literature on the unexplainable injuries he was finding in the long bones in x-rays of infants (Donelly & Oates, 2000). However, it was not until the publication of “The Battered Child Syndrome” by C. Henry Kempe in 1961 that led the general public to become aware of and finally acknowledge child abuse and neglect as a significant societal problem in the United States (Erickson & Egeland, 1989). Dr. Kempe, Pediatric Chair of the University of Colorado School Of Medicine, and his associates proposed the term "battered child syndrome" under the auspices of the American Academy of Pediatrics. When proposed in 1961, the term referred to the PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 4 collection of injuries sustained by children as a result of repeated mistreatment or beatings. The following year The Journal of the American Medical Association published the landmark article "The Battered Child Syndrome" (Kempe, et al.,1962). This eventually led to the passing of mandatory child abuse reporting laws and the Child Abuse Prevention and Treatment Act (Public Law 93-247) in 1974. This legislation authorized federal funding for child abuse and neglect research along with development of child abuse prevention programs (CWL, 2010). Since 1974 the prevention of child abuse and neglect has become a primary national health and social priority in our society. Exhaustive research has led to the implementation of mandated reporting laws in all states and the creation of numerous government and private agencies that have developed and evaluated numerous child abuse intervention programs. Child Maltreatment Statistics In 2009 an estimated 3.3 million referrals, involving the alleged maltreatment of approximately 5.5 million (duplicate) children in the United States, were referred to Child Protective Services agencies. (U.S Dept. of Health and Human Services, 2010). Of these reported cases an estimated 754,000 duplicate and 695,000 unique children were determined to be victims of maltreatment. Of these children 78.3% were neglected, 17.6 percent were physically abused, 9.2 percent were sexually abused, 8.1 percent were psychologically maltreated, and 2.4 percent were medically neglected. In addition, 10.3 percent of victims experienced such “other” types of maltreatment as “abandonment,” “threats of harm to the child,” or “congenital drug addiction.” (U. S. DHHS, 2010). In 2009 in the United States 1,750 children died as a result of abuse and neglect. It has been reported that child abuse and neglect is costing our nation $220 million every day which calculates to a staggering $80 billion annually (Gelles & Perlman, 2012). This takes into account direct costs such as foster care, medical PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 5 treatments, law enforcement, social services, mental health treatment etc. and indirect costs such as lost productivity and adult criminality. In California in 2009 referrals for investigation by CPS were made on 471,776 children, a referral rate of 47.2 per 1,000 children (University of California, Berkely, 2010). In Kern County in the same year, 17,678 children were reported to Child Protective Services with referral rate of 69 per 1,000 children (Kern County Department of Human Services, 2010). In 2009, California reported 140 children died as a result of abuse and neglect and in Kern County 11 child fatalities resulted from abuse and neglect (Kern County Network for Children, 2011). Despite numerous programs put in place to prevent the maltreatment of children, the statistics show that child abuse is still prevalent in our society and that it remains a major health concern for children. Over 56,000 children are currently in the California foster care system and of the 5,219 substantiated cases of child abuse in Kern County in 2009, 1,347 children were placed into foster care (Kern County Network for Children, 2010). The cost of investigating, removing, and protecting reported child abuse cases is high and places a huge financial burden on a national, state, and county level. Based on 2008 data it cost federal, state, and county governments over $1.5 billion for foster care administration and payments (Gelles & Perlman, 2012). An additional $500 million annually goes to child welfare services for children in foster care and their families each year. Billions are also spent through other systems for health and mental health care, special education, court administration, substance abuse treatment, and other services used by foster children and their families (Gelles & Perlman, 2012). These figures do not take into account the “intangible” costs which cannot be quantified in monetary terms such as exposure to violence, lack of basic care, and absence of a nurturing environment. These have all been shown to have destructive, short and long term psychological and physical consequences PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 6 that effect a child’s cognitive, social, and emotional development (Glazer, 2000; Shonkoff & Phillips, 2000). Problem Statement It has been established that certain risk factors are common in families where child neglect and abuse takes place, yet most interventions in these families occurs only after an incident of child maltreatment has been reported to Child Protective Services by a relative, neighbor, or mandated reporter. A report may be the result of a onetime occurrence, however more than likely repeated or chronic abuse or neglect has taken place before a report is finally made to Child Protective Services (Dubowitz, & DePanfilis, 2000). Since child welfare efforts have started in the U.S., the emphasis has been on removal of children and their immediate protection, rather than prevention interventions before the maltreatment takes place. As Wolfe described in (1999). There are many difficulties in providing suitable intervention and prevention services for maltreating families: (1) Those most in need are least likely to seek help on their own; (2) they come to the attention of professionals as a result of someone else’s concern, usually after they have violated accepted norms or laws; and (3) parents do not want to admit to problems due to their fear of losing their children or being charged with a crime: Additional barriers to assistance are created once the families are involved in the Child Protective System. Fees for court, lack of transportation, requirements to attend multiple parenting, substance abuse and anger management classes, create additional challenges to families already lacking resources. Statistics have shown that punitive actions for parents accused of neglect and abuse have not curbed the high incidence of reported child maltreatment nationally or locally. PROVIDNG EFFECTIVE FAMILY SUPPORT SERVICES 7 Family Resource Center programs are based on the family support movement which has its roots in a number of social programs that have evolved over the past 100 years.