parent perspectives on intensive intervention for child maltreatment

Parent Perspectives on IntensiveIntervention for ChildMaltreatment

Mary Russell MSW, Ph.D., Annemarie Gockel MSW,and Barbara Harris MSW

ABSTRACT: Multi-level intervention, based on an ecological perspective, hasbeen promoted at the preferred model of providing parenting support to high-risk families. However, parent views regarding such interventions have notbeen determined. Focus groups consisting of 24 parents who had recentlycompleted an intensive parenting program yielded results supporting multi-level interventions but highlighting processes rather than content within suchprograms as well as the reciprocal effect of particular level interventions.Processes identified at intervention levels included Affirming Parent Self-Worth, Non-Directive Instruction, Promoting Social Connections, andEmpowering Communication. Increased understanding of and attending toprocesses in intensive intervention with high-risk families is indicated.

KEY WORDS: Child maltreatment; Child protection; Parenting.

Successful intervention with parents of children brought to theattention of child protection services has been shown to be a com-plex matter given the multiple and diverse problems that such fami-lies experience (Allen-Meares & Fraser, 2004; Barnett, 1997; Berry,1997). Effective support of such families, therefore, has been foundto require a range of interventions, including attending to theparenting capacity of the parents. A useful way of conceptualizingthis range of interventions is to utilize a multisystem ecological

Mary Russel and Barbara Harris are affiliated with School of Social Work and FamilyStudies, University of British Columbia, Vancouver BC, Canada

Annemarie Gockel is affiliated with Department of Educational and CounsellingPsychology and Special Education, Faculty of Education, University of Education andBritish Columbia, Vancouver BC, Canada

Address correspondence to Mary Russell MSW, Ph.D., School of Social Work andFamily StudiesUniversity of British Columbia, 2080 West Mall, Vancouver, BC, CanadaV6T1Z2; e-mail: [email protected]

Child and Adolescent Social Work Journal, Vol. 24, No. 2, April 2007 (� 2006)

DOI: 10.1007/s10560-006-0068-3

101 � 2006 Springer ScienceþBusiness Media, LLC

perspective that indicates intensive interventions are necessary onmultiple levels (Fraser, 2004a). The goal of such interventions is toassess and address both risk and protective factors at each ecologicallevel in order to promote parenting capacity and family functioning(Nash & Randolph, 2004). In assessing factors at each level,however, professional helpers may find that their views differ fromthose of parents, as parents may view particular characteristics asstrengths whereas helpers view them at risks (Brodsky, 1996).Understanding parents’ perspectives in order to gain a comprehen-sive understanding and to provide interventions that will engageand support parents, therefore is necessary.

In the evaluation of parenting interventions, definitional variationhas been noted in that terms such as ‘‘parenting training’’ or ‘‘par-enting program’’ have been used to describe a wide range of pro-gram intensities from brief didactic teaching to long-termcomprehensive multi-faceted interventions into diverse aspects of afamily’s life (Barnett, 1997). When child maltreatment is the identi-fied problem, parents typically are experiencing a range of problemssuch as family disorganization and distrust of child protection ser-vices, as well as poverty, physical and/or mental health problems,and/or addictions (Reppucci, Britner, Woolard, & Cook, 1997). Inter-ventions, therefore, while including some form of didactic parentingtraining, frequently include a range of other services, sometimesreferred to as family preservation services (Berry, 1997) or intensivefamily preservation services (Fraser, Pecora, & Haapala, 1991).When families are exposed to different intensities of multiple inter-ventions, evaluation of such service requires a more individualizedapproach that seeks to understand the components of interventionsthat parents find beneficial or detrimental. To gain such an under-standing, in-depth exploration of parent experiences is required.

Parental engagement and involvement in not only the servicesprovided but the evaluation of these services has been deemedessential (Lutzker, Bigelow, Doctor, & Kessler, 1998). However, onlya few studies have explored parents perceptions of parenting pro-grams (Chapman, Gibbons, Barth, & McCrae, 2003; Ribner & Cigal,2002; Taban & Lutzker, 2001). Most of these studies, furthermore,have focused on components of programs considered to be most effec-tive, and less attention has been paid to intervention processes(Pecora, Bartlome, Magana, & Sperry, 1991). This is despite theobservation that intervention processes can have significant impacton outcome, particularly in work with high-risk families (Berry,

102 CHILD AND ADOLESCENT SOCIAL WORK JOURNAL

1997; Dawson & Berry, 2002; Thomlison, 2003; Trotter, 2001). Thisstudy, therefore, sought to determine the perspectives of parentsidentified as maltreating their children on benefits and limitations ofthe processes involved in providing intensive parenting interven-tions.

Inasmuch as the ecological perspective has been identified as opti-mal in understanding and intervening with families with multipleproblems (Fraser, 2004b), this study utilizes an ecological model tounderstand parent perspectives. The study focuses on intensiveinterventions with parents identified as maltreating their childrenand referred to a parenting program by child protection authorities.This paper presents the findings of four focus groups that were thefirst phase of a 18-month longitudinal study of parents as theybegin, continue through and continue on after terminating an inten-sive parenting program.

Child maltreatment. The number of children who are abused orneglected per year over the last decade has steadily increased. Inthe United States alone, the number of abuse and neglect casesreported in 1994 reached 2.9 million, reflecting a 27% increase overthe previous 4-year period with the main perpetrators of abusebeing parents (U.S. Department of Health and Human Services,1996). In Canada, approximately 12,000 cases or over 2% of all chil-dren become subject to child welfare investigations in a given year(Trocme et al., 2001). Consequences of maltreatment on a child’sdevelopment are multi-faceted and can include impaired social com-petence, lack of behavior control, low self-esteem and impaired prob-lem solving capacity (Gershater-Molko, Lutzker, & Sherman, 2002;Huebner, 2002). Effective interventions with parents are thereforenecessary to promote healthy development of children.

Ecological perspective. Ecological perspectives have been found tohave considerable utility in understanding problems presented bymaltreating families and in devising comprehensive interventions.Beginning with Belsky’s (1993) application of Brofenbrenner’s (1979,1986) ecological theories to understanding child welfare problems, fur-ther theoretical amplification has suggested the necessity of interven-tion at each of the ecological levels in order to promote acomprehensive remedy to child maltreatment (Fraser, 2004b). Ecologicalmodels have differed in terms of numbers of levels to consider and inthe attention paid to each level in developing and evaluating interven-tions. Belsky’s analysis (1993) consists of three levels including thepsychological-developmental context of the parent, the parent–child

MARY RUSSELL, ANNEMARIE GOCKEL, AND BARBARA HARRIS 103

interactions, and the community/cultural contexts. Within this ecolog-ical perspective, the parent psychological-developmental context hasreceived considerable study. Parental self-esteem, physical and men-tal health, maturity, marital status, perceived stress levels, socialcompetence, communication skill, and substance abuse have all beenfound to be associated with child maltreatment (Cowen & Reed, 2002;Miller-Perrin & Perrin, 1999; Milner, Gold, & Wimberley, 1986). Atthe level of parent–child interactions, parental beliefs and expecta-tions, consistency and frequency of interactions, and responsiveness ofparents are among the factors identified as associated with maltreat-ment (Dore & Lee, 1999; Huebner, 2002; Lovell & Richey, 1991;Miller-Perrin & Perrin, 1999). And in terms of the parental commu-nity context, poverty, social support, and housing are among identifiedfactors (Christmas, Wodarski, & Smokowski, 1996; Gershater-Molko,Lutzker, & Wesch, 2002; Thomlison, 2004).

Intensive interventions. Since the 1990s there has been anincrease in multisystemic intervention approaches that includeinterventions at each ecological level (Corcoran & Nichols-Casebolt,2004), including a range of parenting programs (Dore & Lee, 1999).Evidence suggests that families are be better equipped to deal withchildren’s behavior when working within a multisystemic program(Balgopal, Patchner, & Henderson, 1988; Christmas et al., 1996;Gershater-Molko, Lutzker, & Sherman, 2002). Neglectful families ina study by Brunk, Henggeler, and Whelan (1987) became moreresponsive to their children as a result of an ecological parentingprogram. A number of programs have been developed that have amulti-factor focus including home visits along with aid in meetingthe family’s basic needs (Gershater-Molko, Lutzker, & Wesch, 2002)which have shown to significantly change negative behavioral pat-terns in abusive families to increasingly healthy interaction relation-ship. Balgopal et al. (1988) found that home visits coupled withonsite parent training proved effective with parents who were hos-tile and resistant to such programs. Further aspects of multisystem-ic interventions to parenting that have been implemented includetransportation, meals, and child-care.

Client perspectives. Evaluations of services aimed at promotingparenting behaviors have rarely included feedback from parentsthemselves. Despite the fact that parent engagement, co-operation,and compliance have been significant factor in determining outcomeof child welfare problems (Chapman et al., 2003; Thomlison, 2004),the child welfare system has been said to frequently ignore client


voices (Chapman et al., 2003; Kapp & Propp, 2002). Parent perspec-tives have been included through general measures of satisfactionwith services but evaluations typically have not included compre-hensive exploration of parent experiences (e.g., Chapman et al.,2003; Ribner & Cigal, 2002; Taban & Lutzker, 2001).

Given the need for comprehensive exploration of parent views, an18-month follow-up study was designed to explore views of parentsreferred by protective services to an intensive parenting program.The aim was to determine parent views regarding the beneficial anddetrimental aspects of the multi-faceted interventions they received.As a first step in this process, focus groups were held with parentsrecently having completed the program to determine the generalparameters of parents’ views. The following describes this firstphase of the larger study.

Methodology

Focus groups were held with parents who had completed their par-enting program at two sites, Project Parent Vancouver and ProjectParent New Westminster.

Project Parent. Project Parent is an established parenting pro-gram that is part of the child welfare service delivery system. Theprogram assists parents to find ways to meet the needs of their chil-dren from birth to 12 years of age. There were two iterations of theprogram, one provided in a community setting and the other pro-vided primarily in parent homes. Approximately one-quarter of par-ents participated in the more intensive program serving thosefamilies with children up to the age of five who were in temporaryfoster care or living with relatives under supervision. This programinvolved parents and children being brought together for 2 dayseach week a community site. Transportation was provided for bothparents and children. Meals were provided throughout the day andparents were expected to feed their own children. Child care wasprovided while parents attended individual counseling and groupsessions, and parents interacted with their children in the playroom, settled them for their naps, and discussed child care issueswith play room staff. The alternate, less intensive program wasprovided for the majority (three-quarters) of families. These familiestypically had children under child protection supervision but notpresently in foster care (although the majority had been in foster


care at least once). This program included regular home visitationsupplemented by attendance at group programs at the communitysite where child-care was provided. In all instances individual coun-seling, parenting education groups, coaching and modeling positiveparenting techniques, introduction to community resources, goal set-ting and advocacy with other agencies and resources were included.The program aimed to teach parents limit setting, child develop-ment, effective communication, and effective problem solving withthe goal of increasing safety and well being of children and increas-ing parental capacity in meeting children’s needs. Duration ofprogram was stipulated at either 6 or 12 months, but actual partici-pation ranged from less than 1 month to 2 years.

Referrals were made to the program primarily through the pro-vincial child protection services. The program was offered at two dif-ferent sites and served a total of approximately 150 families peryear.

At-risk Parent Population. Focus group participants wererecruited from the population of parents having completed a parent-ing program. In the majority of cases (60%), these were lone-motherfamilies subsisting on income assistance (78%). The parents’ level ofeducation was typically high school or less (80%), and they repre-sented a diverse cultural mix consisting of Aboriginal (31%), African(26%), Asian or Middle Eastern (18%) and others. Mothers’ agesranged from 16 to 49 with a median age of 33. Fathers’ age rangedfrom 22 to 62 with a median age of 37.

Reason for referral to the parenting program included lack ofparenting skills (34%), problems in parent–child relations (15%),parenting lifestyle (12%), and parent personal functioning (10%). Inaddition, maternal depression was noted in over one-quarter of thepopulation, substance abuse in 20%, and domestic violence in 15% ofcases.

Focus groups. Inasmuch as the aim of this first research phasewas to identify the types of factors identified by parents as contrib-uting to their parenting outcomes, focus groups with parents wereheld. A total of four focus groups were held, ranging in size from 4to 10 participants for a total of 24 participants. All groups were heldin the meeting room on the program site. Parents who hadcompleted or were nearing the completion of their tenure with theparenting program were included. All focus groups were led by thesame two researchers. The format for the parent focus groups includedasking each participant to identify the main benefit derived from


their participation as well as the main challenge they experienced.All group members were then asked to identify changes they hadmade, changes that they would have liked to make and what had orwould have assisted them in the change-making process. Parentswere provided with a $10 honorarium for participation.

Analysis. Focus group interviews were recorded and transcribed.The transcripts were analyzed utilizing aspects of grounded theorymethodology in that transcripts were subject to a line-by-line analy-sis and parents’ views regarding intervention were coded and subse-quently grouped by the constant comparative method, and finallyorganized into themes (Strauss & Corbin, 1990).

Results

Major Theme: Reciprocal Multi-System Interventions. Results indi-cated a consistent over-arching theme of a Reciprocal Multi-SystemInterventions. This over-arching theme described parents recognitionthat complementary and concurrent interventions aimed at them-selves as individuals, their interactions with their children, andtheir integration into familial and social systems all contributed in areciprocal manner to their ability to retain or re-gain custody of theirchildren. Parent level interventions identified as necessary includedthose aimed as increasing parent self-evaluation. Parent–child inter-ventions that were positively described included non-directiveinstruction through modeling of positive parenting methods by staffas well as uncritical comments regarding alternate methods ofchild management. At the social-family level, helpful interventionsincluded those aimed at making connections. And finally, interven-tions at the social system level, included empowering parentalcommunications with the multiple agencies and organizations intheir lives.

Furthermore, parents not only identified interventions at eachlevel, describing the necessity of addressing each aspect in order tobring about maximal positive change but they also described thereciprocal benefits of individual level interventions in that concur-rent benefits were noted in other levels. For example, parent levelinterventions which increased parent self-worth had concurrentbenefits at the parent–child level as parents interacted withchildren in a more confident manner. This supports previousobservations that influencing different ecological levels results in


concurrent changes in other levels as well (Fraser & Galinsky,2004; Thornberry, Lizotte, Krohn, Farnsworth, & Jang, 1991).Within each of the four levels, specific themes were elicitedportraying the specific nature of interventions considered beneficialat the particular level as well as at other levels. These themes andsupporting quotations are as follows.

Parent Psychological Level: Affirming Parent Self-Worth.Enhancement of parent self-evaluation through staff non-judgmentalattitudes and positive reinforcement was a key theme. Parents’experience in being identified by child protection services as mal-treating parents resulted in parental feelings of inadequacy, self-blame and low self-worth. They described how the intervention ofthe child protection system increased their feelings of failure andpromoted a ‘‘downward spiral...toward helplessness’’ (Guteman,2001; Kapp & Propp, 2002). Parents indicated that being identifiedas possibly neglecting or abusing their children decreased theiralready tenuous confidence regarding their parenting. In markedcontrast to their experiences with child protection services, parentsdescribed the overwhelmingly positive impact of receiving a support-ive response from parenting program staff. This positive responseserved to mitigate the effects of their previous negative experiences.As one parent explained:

When you walk in you are thinking what are [staff] going to look atme like? Are they going to look at me like I am this big bad bitchthat’s beaten my kid...you have no self-esteem, no self-confidence youthink you are the rottenest parent...but they [staff] have no accusingfingers...they give you confidence.

This theme of gaining self-worth was a continuous experiencethroughout program participation. Parents described how a mainbenefit of the parenting program was the rebuilding of this sense ofself-worth, the sense that they were not failures in relation to theirchildren. As one mother explained:

I think my biggest hurdle has been looking at my kids and being ableto say I’m okay. I do good things for you. I may not be perfect—But Iam okay. I think that for me that was the biggest hurdle—just to getover the fact that I am not horrible, I am not Satan.

The increased sense of self-worth, furthermore, generalized to theconfidence in their parenting capacities, illustrating the reciprocal


effect of increased self-worth on parent–child interactions. Beingidentified as a maltreating parent frequently had robbed parents ofall sense of adequacy as a parent. As program participation increasedparents’ positive evaluation of themselves, parents regained confi-dence in their parenting ability and were able to appreciate theknowledge that they already possessed. As one parent explained:

If you are having a hard time [staff] are going to turn around andmake you feel good about yourself... And you can say, ‘‘I actually doknow a lot about my kids.’’

Parent comments included frequent references to ‘‘gaining confi-dence in myself’’, and being helped to ‘‘feel good about myself’’. Theynoted that this was due to lack of ‘‘pointed fingers’’ accusing them ofwrong-doing or blaming them for their children’s difficulties. Thisincreased self-confidence resulted in an increasingly optimistic viewof the future. One parent summed it up as follows:

[Staff] give you the confidence to know that what you are doing isokay, that it is the right way, that it is your way and not someoneelse’s way...they give people hope.

This positive view of the future contrasts with the hopelessnessobserved in a group of parents whose children had been removed tofoster care as noted by Kapp and Propp (2002).

In summary, parents who have been identified as maltreatingtheir children experienced a primary benefit of the parenting pro-gram as rebuilding their sense of self-worth and self-confidence intheir parenting capacity. Parents’ reports thus support observationsthat their involuntary engagement with child protection servicesrequiring monitoring, compliance with training and treatmentrequirements, and holding out the threat of child apprehensionserves to increase their feelings of powerlessness and inadequacy asparents (Aikin & Gregoire, 1997; Guteman, 2001). Present resultsindicate that these negative consequences can be countered throughinterventions aimed at promoting parent self-worth. Current resultsalso illustrate the reciprocal effect of interventions aimed at theparent level in that concurrent positive effects on parent–child inter-actions were noted. This affirms observations by Fraser and others(Allen-Meares & Fraser, 2004) that reciprocal benefits at variouslevels may result from single-level interventions. According toparent self-reports, one of the primary benefits of participation in a


parenting program is the restoration, and potential increase, in theirfeelings of self-worth and confidence in parenting.

Parent–Child Level: Non-Directive Instruction. The mode of pro-viding parents information about more effective ways of managingchildren was identified as critical. Parents indicated that informa-tion provided as a suggestion that built on their own experience orallowed them to incorporate a changes into their own parentingstyle was more helpful than a directive to change in a prescribedfashion. One parent summarized this as follows:

The staff is really helpful on giving suggestions on how to try newways of doing things, and letting you try them in your own way. Theydon’t push their ways on you, but are willing to help with suggestions.

Parents indicated that staff observing a difficult interaction wouldsimply offer up suggestions of different ways of handling the situa-tion, rather than implying that parents’ ways of managing the childwere incorrect. One parent summed this perspective up as follows:

They gave us the support programs that we needed... And not so muchpointing fingers at us all the time and saying, ‘‘You have learnedwrong things.’’

And another parent described this process in more detail:

If you’re doing it awkward, they’ll [staff] say, ‘‘Hey look, there’s an eas-ier way of doing it’’ or ,How about you try this way...and see how thatway goes’. They won’t say that you have to do it that way or that youare doing it wrong. They give you that suggestion and which ever wayyou apply that suggestion, that’s your own choice. Because in the end,they say. ‘‘OK, you are the parent. This is your life. This is your child.It is your turn to have control over it’’.

This receptivity of parents to alternate child-rearing methodswhen provided in a non-directive, collaborative manner supportsprevious observations that pro-social modeling, mentoring and pro-cess oriented instruction allows parents to gain ownership of skillsand results in decreased feelings of alienation and increasedprogram engagement (Chaffin, Bonner, & Hill, 2001; Middlemiss,2005; Trotter, 2001). Parents in the present study firmly confirmedthese observations.

Parents, furthermore, were quite explicit in describing how theinterventions aimed at themselves as parents, translated into


positive changes in their interactions with their children. As oneparent explained:

[Staff] also help you find the boundaries between your emotions andyour child’s emotions. When you are stressed out your child is going tonotice it and he or she will act up.

In short, parents not only recognized the benefits of non-directiveinstruction, but they also recognized that such interventions bene-fited their own emotional well-being and had positive effects on theirmanagement of children.

Staff taking time to listen to and appreciate both children andparents served as a model for parents in their own interactions withtheir children. Staff modeling appreciation of and positive interac-tion with children was observed by parents as beneficial and some-thing worth emulating. As one parent explained:

Another thing is to see the joy that they [staff] get from our kids. That’sa big thing. ...You can walk into that playroom right now and you willfind one of them holding one of my kids... It’s nice to see and to feel.

The positive aspects of parenting were frequently lost to parentsburdened with the seemingly overwhelming tasks of providing forthemselves and their children. In modeling the pleasure of interact-ing with children, parents were able to regain that sense of plea-sure, of ‘‘joy’’ that children can represent.

Allowing time for parents to accept, absorb and integrate sug-gested alternative child management methods was also noted as abenefit and served as a model for their own interactions with theirchildren. Parents commented on the unhurried approach of staffwho ‘‘took the time to listen’’. This subsequently translated intochanges in their own behavior as they began to take the time toappreciate their children. As one parent explained:

My biggest accomplishment is being able to listen to what my child istalking about. ...Me being able to listen to his stories and whatever heis telling me... Whereas before I use to say, ,Oh, whatever!’ Now I don’tdo that. I say, ,Oh really! I’m proud of you!’ We are talking and havinggood conversations. That’s my accomplishment.

In summary, non-directive approaches to instruction throughmodeling both with parents and children provided parents withnon-threatening, self-affirming, and unhurried ways to modify their


own parenting behaviors. Parents made it clear that they would nothave been receptive to instruction that was blaming, or suggestedthat their own parenting methods were incorrect. Instead parentviews confirmed that staff modeling and suggestion, coupled withaffirmation of parental capacity, were the most effective interven-tions. Such non-directive interventions that utilize the parents’own knowledge and permit parents to take control of integratingsuggested modifications into their child management have beendescribed as central to the strengths perspective (Berry, 1997;Heinonen & Spearman, 2001) as well as family-centered practice(Dunst, 1997). Parents were furthermore clear that interventionsaimed at their own emotional state had direct impact on theirinteractions with their children, providing support for the notion ofreciprocal effects of single level interventions.

Social-Family Level: Promoting Social Connections. Social isola-tion is a common problem for parents such as ones in this study,who frequently are lone parents, struggling financially, and discon-nected from their own families (Lovell & Richey, 1991). Parents indi-cated that social connection and interaction with staff and otherparents were significant benefits of their program participation. Thiswas particularly true when parent and children suffered from healthproblems. Mental health problems, particularly commonly noteddepression, further exacerbated difficulties in making social connec-tions due to financial and child-care constraints. The parentingprogram, in not only offering transportation and child care, offeredencouragement and follow-up by staff that supported parental socialengagement. As an example, one mother described her experiencesas follows:

I suffer from clinical depression so I don’t go out and socialize verywell. I tend to isolate myself. When [the staff] call up and tell me thereis something going on and you can come out... I find that I really enjoyit. You get support, companionship, and help.

And another mother, whose children suffered from a number ofhealth problems, related her experiences as follows:

I come basically because I enjoy the support of other parents. I have aspecial needs son...who is consistently being expelled from school and Ifind that just being able to come...and having the support from otherparents and all of the facilitators here is one thing that I have notfound at any other parenting program.


Parents here again clearly identify the benefits of the multiplelevels of interventions and the reciprocal nature of these interven-tions. Staff encouragement and support aimed at encouraging par-ents individually, results in parental social engagement with otherparents and staff. This engagement not only provided parents withneeded social support, but also translated into assistance with theirparenting.

Parents also reported the benefits of connecting with other par-ents to facilitate social networking related to management of chil-dren. Other parents provided parenting models, sources ofinformation, and a source of support for problems encountered inparenting. For the socially isolated parents in this study, a processthat provided opportunities for connecting with other parents wasbeneficial. The following words indicate parent perception of thesebenefits:

It’s good for meeting other parents and making friends and getting akind of social network of people that can help out with your kids. Youget to observe what’s happening with other kids and how other par-ents deal with those situations. You can listen to how other moms ordads are struggling with their own parenting issues, and either be ofhelp or get some advice yourself from parents who may already beenthrough that issue.

In summary, a process that promotes connection among parentsand between parents and staff was perceived as a considerable bene-fit by the socially isolated parents in the parenting program. Whenstaff followed up with parents to encourage social participation, par-ents experienced this as supportive of their own emotional well-being, an opportunity to learn more about parenting, and an oppor-tunity to enlarge their own social networks. As with interventions atthe other levels, benefits of such social-family interventions radiatedout to other ecological levels as well.

Social System Level: Empowering Communication. A consequenceof interaction with agencies that are perceived as blaming them forinadequate parenting, is the result that parents frequently respondwith anger and hostility. Such hostile reactions by parents, unfortu-nately serve to decrease the likelihood that they will engage produc-tively with services and resources proffered. Presentation of analternate approach to these authorities in their lives was perceivedby parents to be a beneficial aspect of the parenting program. Par-ents indicated that being able to observe staff modeling alternate


communication and interaction styles with other services, that hav-ing staff accompany and coach them in their own interactions withthese services, and that receiving an increased understanding of dif-ferences between hostile and productive communication modes washelpful. Parents described how they benefited from advocacy ontheir behalf, but also from increased education in dealing with themultiple bureaucracies that impacted their lives. Through observingempowering communications by staff, and by feelings more empow-ered by having staff accompany them to official appointment, par-ents indicated that their communication and interaction changed ina positive direction. One parent described how this impacted herrelationship with the school and the courts:

Because I can go into a school and face a principal with [staff], or Ican face the social worker ...or go to Court with [staff]...

In this context, parents indicated that direct instruction was help-ful inasmuch as they recognized both their lack of understanding ofdifferences between effective and ineffective communication, as wellas the specifics of empowered communication. Comments of one par-ent who explained the lesson she had learned in this regard weretypical:

They teach how to advocate. Because you are your child’s advocate,you have to advocate on their behalf and to speak appropriately. Youhave to be firm but polite. You can’t walk in with a big chip on yourshoulder saying, ,F...you! I’m right and you are wrong!’ [Staff] teachyou how to speak effectively, how to put your point across, let themknow that what they have done is not fair, and what you expect to bedone. [Staff] cover everything, and definitely help teach you how totalk to government [officials].

Given the history of negative confrontations with public agenciesthat many parents reported, this change in attitude and behaviorwas particularly significant. Negative altercations with child protec-tion services, in particular, were frequently referred to. Parents rec-ognized that successful resolution of child protection concerns waspromoted by changing their mode of communication with represen-tatives of these, and other, organizations. Kapp and Propp (2002)noted a similar change in a group of parents with children removedto foster care as they began to share experiences and comparesuccessful ways of navigating the child protection system. Again,the reciprocal benefits of this intervention are apparent given the


considerable impact on child–parent interactions and parent self-worth that can result from more positive and more empowered com-munication with child protection, and other authorities.

Conclusions

Parents clearly identified the benefits of multiple level interventionsin describing helpful interventions that focused on themselves, theirinteraction with their children, their social interactions, and theirinteractions with community organizations and authorities. Parentreports thus supported the prevailing view that interventions basedon ecological models are beneficial in assisting them to provide ade-quate care for their children. The results, therefore, clearly supportthe ecological or multisystems approach to intervention that hasbecome the prevailing social work approach to high-risk families(Belsky, 1993; Fraser, 2004b; Lutzker & Bigelow, 2002). Within themultisystem perspective, parents also clearly indicated the reciprocalnature of intervention benefits. Parents readily identified benefits ofintervention at one level having consequences on other levels. Again,the reciprocal nature of multisystem interventions reported byFraser and others was supported (Fraser & Galinsky, 2004). Paren-tal feedback thus supports prevailing practices and indicates thatmultisystem interventions are necessary in order to support parentsin regaining or maintaining custody of their children when childprotection concerns have been raised.

The importance of process over content was another significantaspect of parent observations. While parents did address specificaspects of interventions, it was the nature of the process that pre-dominated in their reports. Whether at the individual parent level,the parent–child level, the social-family level, or the family-social sys-tem level, parents consistently remarked on the nature of the inter-vention process rather than any specific content. It was the quality ofthe process that influenced the extent to which they were receptive toaims of intervention.

At the individual level, parents declared the importance of theaccepting, non-blaming and supportive nature of the parenting pro-gram. Their experiences with child protection services had resultedin serious misgivings about their own worth as individuals and theircapacity to parent. In contrast, participation in the parenting pro-gram restored, or even increased, their sense of self-worth. This


accords with the more structured findings of Pecora et al. (1991)that indicated parental satisfaction was highest when staff listenedand understood and demonstrated that they cared for the parent asa person. For parents, the positive response from the parenting pro-gram served to promote their engagement in the program and tobenefit from the instruction, modeling and support that was pro-vided. According to parent reports, this process of acceptance andlack of blame provided a necessary foundation for full program par-ticipation. This also accords with previous findings that buildingparental esteem was highly correlated with problem-solving activi-ties and client engagement (Lewis, 1991; Winfield & Barlow, 1995).

At the parent–child level, it was the non-blaming, positive pro-cesses by which instruction was provided that allowed parents toincorporate the suggested alternate parenting behaviors. Modelingand attention to process rather than directive instruction weremethods to which parents were receptive. Given the monitoring oftheir parenting by child protection services, it was apparent thatparents were particularly sensitive to instruction that could beinterpreted as critical of their parenting capacity. In order to secureparental receptivity, therefore, instruction through modeling, sug-gestion, and building on observed parenting strength was effective.

And the social-family level, processes that promoted social connec-tion were valued by the parents. Many parents were socially iso-lated, unable to benefit from peer or social service support becauseof physical or mental disability, and lacked informal networks toobserve and talk with other parents. Promoting peer supportthrough parent group interaction was facilitated in this instancethrough assistance with transportation, provision of child-care as wellas follow-up and encouragement of attendance. And finally, at thefamily-social system level, processes that empowered parents intheir communication with the myriad social agencies involved intheir lives, were perceived by parents to enhance their capacity toprovide adequate care for their children. As parents observed posi-tive outcomes associated with staff communications on their behalf,and as they became receptive to instruction regarding empoweredcommunication, they noted their own increased efficacy in securingsupport for themselves and their children. At each level of interven-tion, thus, positive processes that were perceived to be uncritical,supportive of connections and positive relationships, and ultimatelyempowering in terms of increased parenting capacity were noted byparents as being beneficial.


Finally, parents willingness to engage with an intensive parentingprogram when it was clearly distinct from and countered some ofthe negative effects of their contacts with child protection services,suggests that separation of protection and parent training functionsis desirable. Parents reports that engagement in the parenting pro-gram not only increased their capacity to parent, but also to engagein empowered communication with child protection services regard-ing their children suggests that all parties benefit from this separa-tion. Parent statements in this regard confirm Middlemiss’ (2005)observation that engagement with multiple agencies increasesopportunities to create supportive, protective environments to pro-mote well-being of children and parents. Ultimately, the majority ofchildren remained with their parents and parental appreciation thatservices existed for the benefit of their children and themselvesserved to increase the likelihood they would voluntarily accessservices should they need them in the future. The well-being ofchildren, therefore, can be promoted by parents feeling comfortableseeking help when they need it.

Although the aim of the present study was to explore parentperceptions, the present findings are limited by the fact that theyreflect the views of parents who had successfully completed theparenting program and their views were sought soon thereafter.Perspectives of parents who had not completed the program andwhose views may have been more negative, were not identified.Also, at program completion, parent views can be expected to bepositive as they provide the ‘‘grateful testimonial’’ regarding theservices received (Ware, Snyder, Wright, & Davies, 1983). A morebalanced view, and perhaps a more comprehensive view, is antici-pated from the prospective study that follows parents during andafter program engagement as per the suggestion of Haapala andassociates (Haapala, Pecora, & Fraser, 1991).

Acknowledgement

The Social Sciences and Humanities Council of Canada providedfinancial support for this project through funding the Consortium onHealth, Intervention, Learning and Development (CHILD) under thedirectorship of Dr. Hillel Goelman, UBC.


References

Aikin, B. A., & Gregoire, T. K. (1997). Parents’ views on child welfare’s responseto addiction. Families in Society The Journal of Contemporary Human Services,393–404.

Allen-Meares, P., & Fraser, M. W. (2004). Intervention with children and adolescents: Aninterdisciplinary perspective. Boston: Pearson.

Balgopal, P., Patchner, M., & Henderson, C. (1988). Home visits: An effective strategyfor engaging in involuntary client. Family Perspectives in Child and Youth Services,65–76.

Barnett, D. (1997). The effects of early intervention on maltreating parents and theirchildren. In M. J. Guralnick (Ed.), The effectiveness of early intervention (pp. 147–170). Baltimore, MA: Paul H. Brooks Publishing Co.

Belsky, J. (1993). Etiology of child maltreatment: A developmental-ecological analysis.Psychological Bulletin, 114(3), 413–434.

Berry, M. (1997). The family at risk: Issues and trends in family preservation services.Columbia, SC: University of South Carolina Press.

Brodsky, A. E. (1996). Resilient single mothers in risky neighborhoods: Negativepsychological sense of community. Journal of Community Psychology, 24, 347–363.

Brofenbrenner, U. (1979). The ecology of human development: Experiments by natureand design. Cambridge, MA: Harvard University Press.

Brofenbrenner, U. (1986). Ecology of the family as a context to human development:Research perspectives. Development Psychology, 22, 723–742.

Brunk, M., Henggeler, S. W., & Whelan, J. P. (1987). A comparison of multisystemictherapy and parent training in the brief treatment of child abuse and neglect.Journal of Consulting and Clinical Psychology, 55, 311–318.

Chaffin, M., Bonner, B. L., & Hill, R. F. (2001). Family preservation and family supportprograms: Child maltreatment outcomes across client risk levels and program types.Child Abuse & Neglect, 25(10), 1269–1289.

Chapman, M. V., Gibbons, C. B., Barth, R. P., & McCrae, J. S. (2003). Parental views ofin-home services: What predicts satisfaction with child welfare workers?. ChildWelfare, 82(5), 571–596.

Christmas, A., Wodarski, J., & Smokowski, P. (1996). Risk factors for physical childabuse: A practical guide. Family Therapy, 23, 233–247.

Corcoran, J., & Nichols-Casebolt, A. (2004). Risk and resilience ecological framework forassessment and goal formulation. Child and Adolescent Social Work Journal, 21(3),211–235.

Cowen, P. S., & Reed, D. A. (2002). Effects of respite care for children withdevelopmental disabilities: Evaluation of an intervention for at risk families. PublicHealth Nursing, 19(4), 272–283.

Dawson, K., & Berry, M. (2002). Engaging families in child welfare services: Anevidence-based approach to best services. Child Welfare, 81(2), 293–317.

Dore, M., & Lee, J. (1999). The role of parent training with abusive and neglectfulparents. Family Relations, 48(3), 313–325.

Dunst, C. J. (1997). Conceptual and empirical foundations of family-centered practice. InR. J. Illback, C. T. Cobb & H. M. J. Joseph (Eds.), Integrated services for childrenand families: Opportunities for psychological practice) (pp. 75–91). Washington, DC:American Psychological Association.

Fraser, M. W. (2004a). The ecology of childhood: A multisystems perspective. In M. W.Fraser (Ed.), Risk and resilience in childhood: An ecological perspective (2nd ed. pp.1–12). Washington, DC: NASW Press.

Fraser, M. W. (2004b). Risk and resilience in childhood: An ecological perspective (2nded.). Washington, DC: NASW Press.


Fraser, M. W., & Galinsky, M. J. (2004). Risk and resilience in childhood: Toward anevidence-based model of practice. In M. W. Fraser (Ed.), Risk and resilience inchildhood: Toward an ecological perspective (pp. 385–402). Washington, DC: NASWPress.

Fraser, M. W., Pecora, P. J., & Haapala, D. A. (1991). Family preservation services toprevent out-of-home placement: The family-based intensive treatment project. InM. W. Fraser, P. J. Pecora & D. A. Haapala (Eds.), Families in crisis: The impact ofintensive family preservation services (pp. 1–16). New York: Aldine De Gruyter.

Gershater-Molko, R. M., Lutzker, J. R., & Sherman, J. A. (2002). Intervention in childneglect: An applied behavioral perspective. Aggression and Violent Behaviour, 7,103–124.

Gershater-Molko, R. M., Lutzker, J. R., & Wesch, D. (2002). Project SafeCare: Improvinghealth, safety, and parenting skills in families reported for, and at-risk for childmaltreatment. Journal of Family Violence, 18(6), 377–386.

Guteman, N. B. (2001). Stopping child maltreatment before it starts: Emerging horizonsin early home visitation services. Thousand Oaks, CA: Sage.

Haapala, D. A., Pecora, P. J., & Fraser, M. W. (1991). Implications for practice, policy,research and the future. In M. W. Fraser, P. J. Pecora & D. A. Haapala (Eds.),Families in crisis: The impact of intensive family preservation services (pp. 289–312).New York: Aldine De Gruyter.

Heinonen, T., & Spearman, L. (2001). Social work practice: Problem solving and beyond.Toronto: Irwin.

Huebner, C. E. (2002). Evaluation of a clinic-based parent education program to reducethe risk of infant and toddler maltreatment. Public Health Nursing, 19(5), 77–389.

Kapp, S. A., & Propp, J. (2002). Client satisfaction methods: Input from parents withchildren in foster care. Child and Adolescent Social Work Journal, 19(3), 227–245.

Lewis, R. E. (1991). What elements of service relate to treatment goal achievement. InM. W. Fraser, P. J. Pecora & D. A. Haapala (Eds.), Families in crisis: The impact ofintensive family preservation services (pp. 225–271). New York: Aldine De Gruyter.

Lovell, M. L., & Richey, C.A. (1991). Implementing agency-based social-support skilltraining. Families in Society: The Journal of Contemporary Human Services,563–572.

Lutzker, J. R., & Bigelow, K. M. (2002). Reducing child maltreatment: A guidebook forparent services. New York: Guilford.

Lutzker, J. R., Bigelow, K. M., Doctor, R. M., & Kessler, M. L (1998). Safety, health care,and bonding within an ecobehavioral approach to treating and preventing childabuse and neglect. Journal of Family Violence, 13(2), 163–185.

Middlemiss, W. (2005). Prevention and intervention: Using resiliency-based multi-setting approaches and a process-orientation. Child and Adolescent Social WorkJournal, 22(1), 85–103.

Miller-Perrin, C. L., & Perrin, R. D. (1999). Child maltreatment: An introduction.Thousand Oaks, CA: Sage.

Milner, J. S., Gold, R. G., & Wimberley, R. C (1986). Prediction and explanation of childabuse: Cross-validation of the child abuse potential inventory. Journal of Consult-ing and Clinical Psychology, 54(6), 65–866.

Nash, J. K., & Randolph, K. A. (2004). Methods in the analysis of risk and protectivefactors: Lessons from epidemiology. In M. W. Fraser (Ed.), Risk and resilience inchildhood: An ecological perspective (2nd ed. pp. 67–87). Washington, DC: NASWPress.

Pecora, P. J., Bartlome, J. A., Magana, V. L., & Sperry, C. K. (1991). How consumersview intensive family preservation services. In M. W. Fraser, P. J. Pecora & D. A.Haapala (Eds.), Families in crises: The impact of intensive family preservationservices) (pp. 273–288). New York: Aldine De Gruyter.


Reppucci, N. D., Britner, P. A., Woolard, J. L., & Cook, S. L. (1997). Parent educationand family support for the prevention of child maltreatment. In N. D. Reppucci,P. A. Britner & J. L. Woolard (Eds.), Preventing child abuse and neglect throughparent education (pp. 7–21). Baltimore, MA: Paul H. Brooks Publishing Co.

Ribner, D. S., & Cigal, K.-P. (2002). Client’s view of a successful helping relationship.Social Work, 47(4), 379–387.

Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theoryprocedures and techniques. Newbury Park, CA: Sage.

Taban, N., & Lutzker, J. R. (2001). Consumer evaluation of an ecobehavioral program forprevention and intervention of child maltreatment. Journal of Family Violence,16(3), 323–330.

Thomlison, B. (2003). Characteristics of evidence-based child maltreatment interven-tions. Child Welfare, 83(5), 541–569.

Thomlison, B. (2004). Child maltreatment: A risk and protective factor perspective. InM. W. Fraser (Ed.), Risk and resilience in childhood: An ecological perspective (2nded. pp. 89–131). Washington, DC: NASW Press.

Thornberry, T. P., Lizotte, A. J., Krohn, M. D., Farnsworth, M., & Jang, S. J (1991).Testing interactional theory: An examination of reciprocal causal relationshipsamong family, school, and delinquency. Journal of Criminal Law and Criminology,82(1), 3–35.

Trocme, N., MacLaurin, B., Fallon, B., Daciuk, J., Billingsly, D., Tourgny, M., et al.(2001). Canadian incidence study of reported child abuse and neglect-Final report(No. H49-151/2000E). Ottawa, ON: Minister of Public Works and GovernmentServices.

Trotter, C. (2001). Worker skill and client outcome in child protection. Child AbuseReview, 11, 38–50.

U.S. Department of Health and Human Services NCOCAAN (1996). Child maltreatment1994: Reports from the states to the National Center on Child Abuse and Neglect.Washington, DC: U.S. Government Printing Office.

Ware, J. E., Snyder, M. K., Wright, W. R., & Davies, A. R. (1983). Defining andmeasuring patient satisfaction with medical care. Evaluation and ProgramPlanning, 6, 247–263.

Winfield, H. R., & Barlow, J. A (1995). Client and worker satisfaction in a childprotection agency. Child Abuse & Neglect, 19(8), 897–905.


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