The National Resource Center for Family ... - Marty Beyerby: Marty Beyer, Ph.D. Family visits with children in out-of-home care are an underutilized service which, if carefully orchestrated,

1National Resource Center for Family Centered Practice, Prevention Report 1999 #1

THE PREVENTION REPORT

THE PREVENTION REPORT,published twice yearly, is a publica-tion of the National Resource Cen-ter for Family Centered Practice,The University of Iowa School ofSocial Work, 100 Oakdale Campus#W206 OH, Iowa City, IA 52242-5000, (319) 335-4965. Funding pro-vided by the U.S. Children's Bu-reau, Administration for Childrenand Families. [Grant # 90CW1084]. Copyright 1999 by The NationalResource Center for Family Cen-tered Practice. All rights reserved.

NATIONAL RESOURCECENTER FOR FAMILYCENTERED PRACTICE

The University of Iowa100 Oakdale Campus #W206 OH,Iowa City, Iowa 52242-5000Phone: (319) 335-4965FAX: (319) 335-4964

Ashly Bennett, Editorial Asst.Debbie Black, SecretaryJohn-Paul Chaisson, Trng. Assoc.Barb Christensen, Training Dir.Miriam Landsman, Research Dir.Judy McRoberts, Research Assoc.Sarah Nash, Training Admin.Margaret Nelson, Fin Admin.Kim Nissen, Pub. SecretaryJennifer Paris, Info. SpecialistPatricia Parker, Trng. Assoc.Salome Raheim, DirectorBrad Richardson, Research Assoc.John Zalenski, Info. DirectorDebbie Zeidenberg, Res. Assoc.

Family Resource Coalition ofAmerica, 20 N. Wacker Drive,Suite 1100, Chicago, Illinois60606Phone: (312) 338-0900FAX: (312) 338-1522Project Director: Sharon Sneed

National Indian Child WelfareAssociation, 3611 SW Hood,Suite 201, Portland, Oregon 97201Phone: (503) 222-4044FAX: (503) 222-4007Project Director: Terry Cross

The National Resource Center for Family Centered Practice 1999 #1

Support for ASFA Reforms ...

t Parent-Child Visits as anOpportunity for Change

t Building NeighborhoodPlace: Lessons LearnedThrough Developing aNew Human ServiceDelivery System

t Voices of Experience: TheWork of BuildingPhiladelphia's FamilyCenters

t Three Dimensions ofManaging Change inSocial Service Reform

PLUSt Research Exchanget Resource Reviewt Materials Available

In this issue...

For more than twenty years, the National Resource Center for Family Centered Practice has worked tobuild the many dimensions of a family centered child welfare service system. From the first generationof diversionary programs aimed at placement prevention, through increasingly complex interagencycollaboratives focused on integrated services and systems reform, the Center has provided consultation,technical assistance and training, research and evaluation, and detailed information to an evolving field,through this work sustaining progress in the effort to build a continuum of services adequate to the needsof vulnerable children and families.

Over the years we have worked on major pieces of federal legislation impacting child welfare families,most notably the Adoption Assistance and Child Welfare Act of 1980 (“96-272”), which brought“reasonable efforts” into our lexicon, The Family Preservation and Support Services Program (FPSSP),which funded, in 1993, a locally based collaborative services agenda, and now the Adoption and SafeFamilies Act (ASFA). Through all of these legislative eras our goal has been to maintain consistencyand continuity of practice as we help states and agencies respond to new mandates and service goals.

ASFA will be two years old in the fall of 1999, and its systemic and practice implications, obscured inits first year by the overlap with the original appropriation for FPSSP, are emerging in full force.Finding a funding allocation formula to meet the mandates of the legislation while consolidating thegains in community capacity made under FPSSP is difficult. Creating services, such as familyreunification, needed to effectively support stringent permanency timelines requires substantialorganizational and program development. Building practice strategies adequate to the promise ofconcurrent planning requires commitment to a range of staff development activities.

In this issue of The Prevention Report, we offer a variety ofresources to help with these many tasks. Marty Beyer’s articleon parent visitation addresses challenging issues at the heart ofsuccessful reunification. Martin Bell’s discussion of lessonslearned implementing a community partnership for protectingchildren helps us focus on progress within the challenging workof building partnerships. Gerald Smale’s work on organiza-tional development presents some of the key skills needed tobuild leadership for successful reforms in sometimes dramati-cally changing systems. These, as well as other features andarticles in this issue, reflect the Center’s commitments to conti-nuity and change.

One new feature of The Prevention Report is the “learningexchange” . We believe that much has been learned over the pastfive years, and longer, in the field of family centered services. Ithas been a time of extraordinary innovation and experimenta-tion. Yet much of what has been learned resides in the experienceand practical knowledge of people at all points in and out of thesystem who have struggled to solve the problems of creating aresponsive service system. The learning exchange approach isan effort to find an outlet for this accumulated practical knowl-edge. Through different forms of support, from ghost writing, toco-authorship, to editorial support, we would like to help bringthis practice knowledge to others. If you have an idea aboutdisseminating what you have learned but want support in youreffort to write about it, please contact us.

2 National Resource Center for Family Centered Practice, Prevention Report 1999 #1

Parent-Child Visits as an Opportunity for Changeby: Marty Beyer, Ph.D.

Family visits with children in out-of-home care are an underutilized servicewhich, if carefully orchestrated, can be the determining factor in safereunification. Although research connects visits with children returninghome and shorter foster care placement, in most child welfare systems visitsare rarely more than a supervised encounter in an office.1 Parents often feelthat visits are permitted begrudgingly, as if only to satisfy their legal right tovisit; and visits may be withheld if the parent is not complying with drugtesting, mental health evaluation or parenting class. Visits can be inconve-nient for and stir up ambivalence in the family, caseworker and foster familyand cause behaviors in the child that are often misunderstood.

Nevertheless, most children need visits to maintain their family attachmentsand comprehend what has happened to them. Visits are also an importantopportunity for parents to increase their understanding of and ability to meettheir children’s needs. Parents’ concepts of their children’s needs may bedifferent from that of the worker, teacher, or therapist. They may view thesafety needs for which the child was removed from home as luxuries ratherthan true non-optional needs. Parents’ own needs may obscure their children’sneeds—for example, parents’ desperation to see their children can makethem unable to stand in their children’s shoes and see things from theirperspective during visits. Parents may act out their anger about theirchildren’s removal or conduct business with the worker during visits insteadof attending to their children. Consequently, it is not uncommon to haveperfunctory visits for months or years without agency staff believing thechildren could be safely returned.

In current child welfare practice, visits typically do not attempt to changeparenting practices—other than by providing protection in the form ofsupervision, most visits do not address the abuse or neglect that brought thechild into care. For a parent to use visits to improve his/her responsivenessto the child’s needs requires individual coaching and conducive visitingconditions. Initially the coach may concentrate on helping the parent under-stand his/her child’s needs by discussing the child’s behavior and the parent’sresponses in the visit. Then approaches to meeting those needs in visits canbe developed by building on the parent’s strengths. A variety of individualscan provide effective parent support during visits, including foster parents,case aides, parenting skills instructors, school counselors, therapists, and theparent’s domestic violence or substance abuse treatment counselors. Theindividual providing visit support must work closely with the caseworker toensure that they identify—along with the parent—needs of the child to be metduring visits that reflect the changes in parenting necessary for a reunifica-tion process to begin.

The purpose of this article is to describe how to make supported visits apowerful child welfare tool.2 Children’s reactions to visits, parents’ ambiva-lence about visits, and foster parents’ responses to visits are discussed. Usingvisits to help parents improve their ability to meet their children’s needs isalso discussed. Then a proposal for a visit program is offered, as well as a listof visit principles (on pages 11-12) that can be used by individuals involvedin visit support.

I. REACTIONS TO VISITATION

Responding To Children's Visit Reactions

It is normal for a child removed from homebecause of neglect or abuse to have reac-tions to visits. These reactions usually arenot a sign that the visit did not go well or thatthere is something wrong with the foster orrelative home where the child is placed.Children’s reactions to visits typically in-clude a mixture of some or all of the follow-ing:

l The child is happy and relieved to seehis/her family because he/she missesthem.

l The child is confused, especially aboutwhy he/she cannot go home. Theyounger the child is, the more con-fused he/she will be about having twosets of parents, especially when otherchildren in the home call the fosterparents “mom” and “dad.”

l The child is angry about the maltreat-ment and may be fearful of the parent.

l The child feels sad and angry aboutbeing separated from family, feelinghe/she has lost everything familiarand cannot count on or control any-thing.

l The child believes that being takenaway from home is his/her fault.

l The child feels worried about beingdisloyal to his/her family by liking thefoster family.

l The child feels worried about whetherhis/her siblings and parents are okay.

l The child is defensive when he/shesenses criticism of the family.

Most children do not put these feelings intowords; instead, their behaviors reflect theirfeelings.3 Regression (acting babyish, de-manding, fearful, and/or whining), numb-ing or denying of feelings, depression, night-mares, irritability, wetting, aggression,overactivity, inattention, and physical painsare common prior to and following visits.Children may express anger toward the fos-ter family and/or the biological family be-fore, during and after visits. Some children

parent-child visits ______________________________________________________________________



cling to the foster parent or to the parent.And, some become intolerably controllingbecause of the feelings stirred up by visits.Parents, foster parents, case aides, casework-ers, teachers, therapists, and others can reas-sure children by helping them put the feel-ings motivating their behaviors into words,and by helping them understand at their levelwhat is happening to them and how to livewith their confusion.

Separation from families causes children tomourn. When children are helped with thismourning, the harm caused by separationcan be reduced. Consider this case example:

A 2-year old was placed in a fosterhome from the hospital where she wastreated for a serious leg fracture thathad been inflicted by her 20-year oldmother’s boyfriend. Her mother hadbeen in a series of battering relation-ships and started treatment in a do-mestic violence program. The childhad a strong attachment to her motherand was irritable and clingy and hadnightmares in the foster home becauseshe missed her.

Frequent visits were necessary to meet this2-year old’s need for familiar nurturing andreassurance that her mother loved her. Asthis case suggests, every effort must be madeto enable a child to see his/her family soonafter separation. In the long run, harm isdone by keeping children and their parentsapart:

To avoid [visitation] on the groundsthat it will prove unpleasant or trau-matic is to encourage the child to re-press the experience . . . Generallyspeaking, those children who do bestin long-term foster care are those whoremain secure in their foster homes buthave continuing access to natural par-ents to whom they remain attached buton whom they cannot depend for thecaring, consistency and guidance theyneed. Visits with the natural familyshould be used to make it possible forthe child to maintain the continuity ofimportant relationships; to remain intouch with—that is, to have stirred up,and therefore available to casework—the feelings and conflicts left unre-

solved since coming into care; to helpthe child see directly the reasons forcoming into care. By stopping visitsthe relationship with the parents is noteliminated; this merely encourages thechild to idealize and perpetuate infantasy the absent parents rather thanto seek solace in new relationships.4

An obstacle to empathizing with the child’sgrief and visit reactions is the natural ten-dency to blame the parent, both for themaltreatment and for a variety of other as-sumed parenting deficits. It is a common,unexamined practice to attribute behaviorthat is “maladjusted” or not age appropriateto deficits in the child’s parent, based onassumptions about the family. But, usuallylittle is known about a child’s behavior priorto being separated from family membersand familiar surroundings. The child mayhave been functioning adequately prior toremoval, which would suggest that oneshould pay attention to separation, mourn-ing and anxiety as factors in the child’s visitreactions and behavior in foster care. Or, thechild may have regressed from previoushigher functioning as a result of family stres-sors just prior to removal, which wouldsuggest paying attention to the way thoseexperiences compound the effects of beingseparated from family and familiar surround-ings. Of course, sometimes children are de-layed or aggressive because of abuse orneglect.

Mental health literature contributes to polar-ized interpretations of children’s visit reac-tions. One area of research indicates thatseparation itself causes traumatic loss forchildren. From this evidence came the viewthat children must be helped to grieve inorder to make new attachments; failedmourning is seen as the source of subse-quent emotional and behavior problems.Later researchers suggested instead thatchildren’s attachment difficulties and be-havior in foster care predated the separationand were the results of earlier problems inthe parent-child bond. There is a tendency tobase practice on either one theory or theother, ignoring the obvious likelihood thatseparation is traumatic and affects the child’sadjustment and that children will have evenmore adjustment difficulties if prior to re-moval they experienced stress in the family,

and even more if they are poorly equippedpsychologically because of longer inconsis-tent nurturing.

Consider this case example of a child whoreacted strongly to separation from hermother and to visits:

Diana, a 4-year old child who hadnever slept anywhere other than inher mother’s bed, was placed in afoster home when her mother wasarrested for possession of drugs.Within the first two months she wasmoved several times because fosterparents could not manage her attemptsto run away to her mother, long cry-ing spells, enuresis, and temper tan-trums. The caseworker described tear-ing the child kicking and screamingaway from her mother at the end ofvisits. A mental health evaluator as-sessing these behaviors attributedthem to the mother’s failure to social-ize the child, never mentioning at-tachment or separation in the report.The evaluator interviewed the childonce, got a behavior checklist fromthe foster mother, and neither met themother nor observed parent-child in-teraction.

The initial focus on Diana’s physical safetyis not surprising: she could not be left alonewhen her mother was arrested. But, in sucha case, it is important not to attend only to thechild’s safety needs, without regard to his/her attachment needs. Diana was attached toher mother, and if she could, she might havedescribed her separation from her motherpoignantly. She missed her mother: sleepingwith her mother, her mother’s smell, hermother’s way of patting her to make her feelbetter, her mother’s food. She missed herapartment: her blanket, her toys, her hairbarrettes. She did not like the way the fosterhomes smelled. She missed her old routine.She wasn’t used to waking up early or goingto bed early. She’s wasn’t used to so manybaths. She didn’t like the way her fostermothers did her hair. And she missed herfriends in the apartment next door.

These were a lot of losses for a 4-year old.No one, not even her mother at visits, could



explain why her mother went away. Theworst thing was that her mother did not takeher home with her. Diana did not understandwhat was happening to her and believed itmust be her fault. She did not put either whatshe missed or how confused she was intowords. Even during visits where she couldconfide in her mother, she was so over-whelmed with missing her mother that shewould cling and not talk much. But later sheacted out her feelings: she screamed, kicked,and wet. Nights were the worst. She wouldtry to get out of the foster home to find hermother. Every time she was placed in adifferent home, she would re-experience herlosses and blame herself.

The caseworker’s perspective on visitschanged when she stood in Diana’s shoesand tried to understand how attachment andloss felt for her. She recalled, “One thing Ilearned was that it was a sign of attachmentthat the child protested so much, althoughthe foster parent and my supervisor tooksome persuading to believe it after that criti-cal mental health evaluation.”

Diana’s case exemplifies the disagreementthat can arise over a child’s visit reactions,which often leads to a reduction in visits thatis harmful for children:

Controversies arise around visitation. . . in interpreting young children’sregression, and usually involves is-sues of attachment. Often regressionis interpreted as a reaction to an up-surge of attachment feelings, and dis-agreement arises about the value ofthese feelings. They may appear to beterribly disruptive to a child, but thisdisruption may be necessary to sus-tain attachment to the visiting parent. . . Like any problems of children,visitation problems can seem to springfrom one of two choices: processesinside the child, or processes in theenvironment . . . Controversies aboutthe meaning of visitation problemsoften stem from focusing too closelyon one of these areas to the exclusionof others . . . Such conflicts can eveninvolve clinical experts lining upagainst each other on opposite sidesof a visitation controversy . . . anyclinical evaluation of a visitation prob-

lem should include an adequate as-sessment of the child and of bothcustodial and visitation contexts. Therelative importance of factors fromeach area—intrinsic, visitation, andcustodial—should be examined toclarify in which area the source of thedifficulty may lie . . . Often, simpleexploration and clarification of thesecomplicated issues with parents andagencies is sufficient to defuse con-flict and enable consensus to be built. . . 5

Visitation with a reluctant or frightenedchild requires supportive supervision. Thechild’s therapist must also be informed aboutthe findings of research on visitation andcommitted to meeting the child’s attach-ment as well as safety needs. For example:

An 8-year old who was acting outfollowing his sexual abuse by a neigh-bor was placed in a special school.The school called his single mother atwork to pick him up several times aweek because he was unmanageable.She asked for help from the mentalhealth center and was placed on awaiting list. She became less and lessable to handle his behavior. One dayshe failed to pick him up at school,and he was placed in a foster home.He was furious at his mother for herabandonment, inability to help him,and lack of protection. He startedtherapy and his therapist argued thathe should not be forced to visit hismother because he was angry at her.The mother’s therapist encouragedtherapeutic visitation to help the boyexpress his anger at his mother and tosupport his mother to respond lov-ingly, which were important needs.

This child had been angry with his motherfor years. He needed reassurance that hisanger would not get out of control duringvisits and that his mother would not beangry at or reject him. Ways to offer himsufficient protection to make the visits toler-able included: the presence of his therapist,the child controlling the activities with hismother and their physical proximity to eachother in the visit, the child practicing inadvance how he could express his anger to

his mother, the child being promised that ifhis mother got angry she would be asked bythe therapist to stop, and the child beingallowed to leave the visit. As this caseillustrates:

Handling the regression in responseto visitation thus calls for the sameresponses appropriate to any devel-opmentally appropriate stress, i.e.,emotional support and opportunitiesfor mastery. Agency workers, visit-ing parents, and, especially, custodialparents on whom young children willlikely be most dependent for supportand understanding all need to under-stand what the specific value is of thevisitation experience. They need thento help the child to understand howvisits will be good for him or her, totolerate the stress of visits, and todevelop ways of feeling more in con-trol.6

In certain cases, such as when children arefearful of abusive parents or parents in-volved in domestic abuse, or when a sexu-ally abused child might recant hoping toreturn home, the child’s attachment to eachparent must be appreciated (independent ofthe harm inflicted in the past) as the basis formaking decisions about visits. Then thechild must be supported in whatever waysmeet his/her needs, which may include hav-ing the child’s therapist present during vis-its or, in extreme cases, initiating visitsthrough videotaped messages exchangedbetween the child and parent. Concrete rulesfor visit behavior that parents help to de-velop and agree to adhere by, and that arebased on the child’s need to be safe, can behelpful, as well as giving the child permis-sion to leave if the visit becomes too diffi-cult.

Painful disloyalty pressures can plague achild in care, and encouraging a child to livehappily in two different families can helprelieve these. However, enabling the childto see the strengths of both families is acomplicated process requiring active sup-port of reunification by foster parents andtherapists who believe that the child’s bio-logical family can learn to provide a mini-mally adequate home.



Thus, children normally have reactions tovisits—and they often act out their mixedfeelings in behavior rather than words—which does not necessarily mean that visitsare harmful or that there are problems withthe foster placement. Understanding thechild’s feelings before, during and aftervisits is essential in order to design neededsupports for the child, parent and fosterparent.

Parents’ Ambivalence About Visits

Parents whose children have been removedare often in shock for a long time. The lossof their children combined with feelings ofguilt about the maltreatment can take a toll.When parents come for visits, most havedifficulty managing their sadness and havepositive and negative feelings battling in-side them. Parents’ reactions to visits typi-cally include a mixture of some or all of thefollowing:

l The parent is happy to see his/herchild.

l The parent feels shame regarding themaltreatment, although this may takethe form of denial.

l The parent feels guilty when the childasks “Why can’t I go home with youtoday?”

l The parent is loving, showing this inpart by reclaiming the child by doinghis/her hair, straightening clothes,teasing, using nicknames, and cud-dling.

l The parent feels defensive becausehis/her parenting is being criticized.

l The parent is resentful because he/shefeels that he/she has the right to visitthe child and cannot control the time,place, length or frequency of visits.

l Because of the parent’s fondness forthe child, he/she exaggerates thechild’s ability to sustain their relation-ship without frequent contact.

l The parent feels competitive, desper-ately wanting his/her child’s allegiance(and possibly undermining the fosterparent without knowing it).

The parent’s pain of separation from his/herchild is articulated well by Rutter:

When the loss of your child first hits

you, it is like going into shock. Youmay cry, feel shaky, and find it hard tohear what people are saying to you.You can’t think of anything exceptthe child who has been placed . . . Asyou come out of the numbness ofshock, you experience sadness, angerand physical upset. Some people losetheir appetite, others eat constantly. Itmay be hard to fall asleep. You mayincrease your use of alcohol, ciga-rettes or sleeping pills. You may findyourself suddenly tearful over noth-ing . . . You are angry with God . . . youare furious at the social agency, thecourt and everyone there. You aremad at yourself . . . you resent [yourchild] for making you go through allthis pain. Many people get scared athow angry they are or feel guilty aboutthe anger and start avoiding their childor their worker . . . Some people staywith being angry because it hurts lessthan the next step, which is despair . .. you go into the blues. You may feelyou don’t care about anybody or any-thing. It isn’t worth getting up eachday and nothing interests you. Youmay feel worthless and no good. Ifyou are a single parent and all yourchildren have been placed, you mayfeel desperately lonely. You don’tknow who you are without your chil-dren to care for.7

This confusing mixture of feelings is unset-tling to parents, who as a result may notfocus on or understand their child’s needs atvisits:

Visiting parents often respond ini-tially to visitation with awkwardnessand pain, especially when the separa-tion from the child has been involun-tary and when the visit presents anunfamiliar context to the parent. Vis-iting parents commonly hope that vis-its will soothe painful feelings by rec-reating closeness between the parentand child. However, many parentsfind that they do not feel better after avisit. Instead, the awkwardness andintensity of the visiting experiencesleaves them feeling more isolated andcut off from their children than be-fore. Some parents find the visiting

experience itself so painful that theyavoid visiting. Other parents may tryto overwhelm the awkwardness of thevisiting situation with activity or gifts,leading to a rush of overindulgence.8

As the quote suggests, parents often feelmore inadequate after visits and conse-quently avoid them. Or, parents may get sodiscouraged when they see no progress to-ward reunification that they behave incounter-productive ways, including miss-ing visits.

Some parents show their sadness about los-ing their children by using visits to confrontthe caseworker about their treatment by “thesystem.” It is a challenge for a worker tohelp a parent who is furious at the police,court and agency about the child’s removalput aside his/her anger. But it is importantbecause a parent who remains angry willhave much more difficulty visiting consis-tently and focusing on the child’s needsduring visits. Also, parents’ anxiety mayincrease with their awareness that the onlyopportunity “the system” has to view themwith their child is during visits. Parents maybe helped to put their anger and anxietyaside if they understand, from the child’sperspective, the importance of consistentvisits. If a parent is not visiting, an approachto alleviating his/her anger is to say, “I wantto help you get your child back. The quick-est way to do that is to start visiting. Whenwould it be most convenient for you to visitthis week?” Since parents may have diffi-culty managing their sadness and anger whenthey see their children, they will benefitfrom being prepared about what to bring tothe visit and how to meet the children’sneeds by what is and is not talked about inthe visit.

Foster Parents’ Ambivalence About Vis-its

It is not surprising that foster parents alsohave mixed feelings about visits becausethey live with the children and have to copewith the children’s reactions to visits. Fosterparents’ reactions to visits typically includea mixture of some or all of the following:

l The foster parent is glad that the childis reassured by seeing family mem-bers.



l The foster parent has agreed to pro-vide a temporary home while thechild’s birth family improves andwants visits to serve the goal of reuni-fication.

l The foster parent is critical of the birthfamily’s parenting, lack of protec-tiveness and failure to prevent devel-opmental delay, and may be unfor-giving about visits missed by the par-ent.

l The foster parent resents the disrup-tion of the household routine and hav-ing to deal with the child’s reactionsto visits.

l If the foster parent is struggling fortherapeutic reasons to get the child toattach to him/her, he/she may resentvisits if they seem to weaken the child’stie to the foster parent.

l The foster parent may believe thechild should not be reacting so stronglyto separation and may blame thechild’s behavior on the birth family’sneglect or abuse.

Making adjustments in the foster home for achild’s reactions to visits is challenging, butindividual post-visit nurturing is crucial. Afoster parent’s natural blaming of the parentfor harming the child can often make itdifficult to empathize with the child’s feel-ings about separation and responses to vis-its. The more the foster parent cares for thechild, the angrier he/she may become at theparent who has mistreated the child. Thisinfluences how the foster parent interpretsthe child’s reactions to visits: rather thanconcentrating on meeting the needs reflectedin the child’s behavior, the foster parentmay think visits should stop.

Foster parents benefit from being helped tounderstand children’s reactions to visits andthe importance of visitation, and in somecases being involved in visits. For example,it would be a challenge for foster parents tomanage the behaviors of 4-year old Dianathat were described earlier, particularly thecrying, wetting, and running away. Theynaturally would be stressed by every visitbetween Diana and her mother. The fosterparents could comfort Diana more effec-tively if they saw her regressed and aggres-sive behavior as a reflection of loss, insteadof blaming Diana’s mother for inadequately

socializing her or viewing Diana’s behav-iors as acting out against them. They mightseek to increase Diana’s visits with hermother, as well as provide telephone con-tact. They might get a videotape of Diana’smother preparing her daughter for bed reas-suringly that Diana could watch at night.And, they might talk with Diana’s motherabout her routines and food and attempt tomake her life in care more similar to her lifeat home. If Diana’s foster parents becameinvolved in visits, they might appreciateDiana’s attachment to her mother more andbe able to respond more supportively. Thesesteps are important not just to ensure thatvisits go more smoothly but also to preventplacement breakdown.

II. USING VISITS TO HELP PARENTSIMPROVE THEIR ABILITY TO MEETTHEIR CHILDREN’S NEEDS

Visits are a service that helps parents reallyunderstand their children’s needs and en-hance their parenting skills. Visit supportshould include:

l Reaching agreement with the parentabout the child’s needs.

l Preparing the parent about what toexpect regarding his/her own feelingsand the child’s reactions at visits.

l Supportively reminding the parent im-mediately before and during the visithow he/she plans to meet particularneeds.

l Appreciating the parent’s strengths inresponding to the child and coachinghim/her to improve.

l Recognizing improvement.l Helping the parent master his/her visit

reactions so he/she visits consistently.

The following are examples of specific is-sues that can be addressed through visitsupport to help parents improve their abilityto meet their children’s needs:

Example: Visits to Help a Parent Changehis/her Approach to Discipline

When a child is removed, a significant safetyworry can be that the parent’s approach todiscipline is harmful to the child, particu-larly in excessive punishment, domestic vio-

lence and some substance abuse cases. Aparenting skills class that prohibits physicalpunishment and advocates time outs mayseem culturally biased to a parent, and he/she may think it does not make sense to tryout such unfamiliar techniques. Hands-oncoaching during visits can help a parentchange his/her disciplinary approach, but itmust recognize that (1) the parent will onlyimplement something new if he/she reallybelieves it is better for the child; (2) the newapproach has to fit the parent and child; and(3) the parent will change if he/she has a realunderstanding of the complex interactionbetween the parent’s discipline methods andthe child’s response.

Two aspects of discipline that may haveimportance for children’s safety can betaught through parent support in visits. First,parents can be made aware of the harmfulconsequences of viewing children as “bad”rather than seeing that their behavior often isnot intentional and is normal for their age.Second, parents can be taught that parentaldiscipline methods are less important thanthe flexibility of their use and the child’sperception of their acceptability in differentsituations.9 Many parents would be sur-prised to learn that their children distinguishbetween, for example, hitting and not shar-ing, and see punishment as fairer in re-sponse to harmful acts than to failure toshow concern for others. Through visitsupport, parents can develop an approach todiscipline that

. . . considers interrelationships be-tween the form of discipline and vari-ables that include characteristics ofthe child’s misdeed, the child and theparent . . . This reformulation requiresthat parents be flexible in their disci-plinary reactions, matching them tothe child’s perceptions of and reac-tions to the conflict situation: Effec-tive parenting involves sensitivity tothe child’s emotional state and cogni-tions . . . internalizations needs to beviewed as a two-pronged event. Chil-dren must accurately perceive the mes-sage parents intend to convey, andthey must be willing to accept themessage, that is, allow it to guide theirbehavior. Acceptance involves threecomponents: the child must perceive



the message as appropriate, the childmust be motivated to comply with themessage, and the child must feel themessage has not been imposed but hasbeen self-generated.10

Parents should be encouraged to reasonwith their children rather than asserting theirpower, since “Parents who tend to be harshlyand arbitrarily authoritarian or power asser-tive in their parenting practices are lesslikely to be successful than those who placesubstantial emphasis on induction or rea-soning, presumably in an attempt to be re-sponsive to and understanding of their child’spoint of view.”11 Reasoning that empha-sizes the negative effects of the child’s mis-deed on others will develop the child’s em-pathic capacities. Difficult children pushtheir parents to abuse their power, but powerassertion arouses hostility in the child aswell as an unwillingness to comply with theparent’s wishes. Furthermore, when the par-ent loses control of his/her anger, humiliatesthe child or withdraws love, the child be-comes insecure. In many physical abusecases where there is a high risk of re-abuse,the parent gets the message that the agencyrequires that no marks are left on the child.What the parent is not helped to understandis that children feel betrayed when the par-ents they love hurts them, and this will affectthem for a long time.

In a supported visit, the coach helps theparent see that the child:

l Needs to accept the reasoning behindthe parent’s limit-setting in order tofoster the child’s self-controlling ca-pacity.

l Needs redirection before behavior getsout of control.

l Needs reasonable punishment if themisbehavior is a harmful act.

l Needs to learn to see how others feelwhen he/she fails to show concern forthem, rather than being disciplined.

The coach helps the parent understand theseneeds, meet these needs during visits andprogress to being able to meet them withminimal assistance during longer home vis-its.

Example: Visits to Help a Parent WhoCan’t Accept the Abuse

In cases of physical or sexual abuse byothers, non-offending parents often find itdifficult to accept that their children havebeen abused and to face responsibility forharm to their children. They may feel defen-sive and increasingly isolated because of theinsistence on a “confession” of their respon-sibility. Sometimes these parents do notwant to lose their relationship with the per-petrator. Often these parents do not want tobelieve their children have been “tainted”by sexual or physical abuse. “Confessing”in their eyes reduces them as a parent, whileinsisting that the child is undamaged seemsprotective. Usually these parents do not seethe child’s need to be believed as a true, non-optional need, and this need of the childconflicts with the parent’s need to view thechild as undamaged. The parent may notrecognize that harm occurs to children whenthey are not believed by their parents.

Visit support can help a parent meet thechild’s need to have the abuse acknowl-edged. The coach, who might be the parent’stherapist, encourages the parent to stand inthe child’s shoes and see the child’s need tobe believed. The coach helps the parentfigure out how to believe the child initiallywithout “confessing” responsibility for fail-ing to protect the child. He/she practiceswith the parent how to express belief in whatthe child says. The coach also helps theparent see how his/her own needs to be agood parent and have an undamaged childcan be managed so they do not get in the wayof having empathy for the child. After show-ing belief in the child’s story, the parent willneed help facing the child’s questions aboutthe failure to protect the child and the parent’splans for protecting the child in the futurefrom possible perpetrators. The coach helpsthe parent meet the child’s needs duringvisits and progress to being able to meetthem during longer home visits, which mayrequire that the child and parent participatetogether in family treatment. Parallelprogress in the parent's individual treatmentto understand dependency, become moreemotionally self-sufficient, and get out of apattern of relationships with the same typeof partner should be coordinated with visitsupport.

Example: Visits to Help a Parent Be MoreAttentive

Passive or depressed parents may love theirchildren but not provide sufficient indi-vidual attention to meet the children’s needs.They may not be aware that the infant needsto be held and stimulated rather than proppedin a carrier. They may not know that tod-dlers need to play with their parents. Theymay underestimate the structure and super-vision older children who seem self-reliantactually need. Frequently these parents seemcompliant in parenting skills class becausethey want what is best for their children. Butthey do not apply what they have learnedbecause they do not believe their childrenreally need more from them.

Since parents often have to deal with thedemands of seeing several children simulta-neously during visits, a supported visit is agood opportunity for a parent to identifyeach child’s specific need for individualattention and to learn how to provide it. Thebest coach may be an individual with expe-rience in early childhood education or thefoster parent. The coach can begin visitswith one child at a time, helping the parentbecome more active in providing the childwith individual attention and then progres-sively adding children. At the beginning ofvisit support, needs statements might besimple, such as:

l The infant needs to have the parentlook into his/her eyes while being fedthe bottle.

l The infant needs to be talked to orsung to while the parent holds thechild.

l The child needs to have the parentplay on the floor with toys of thechild’s choosing.

l The child needs to have the parentfollow the child’s lead in play, such asthe parent playing a role the childassigns in make-believe or the childdirecting follow-the-leader.

l The child needs to have the parent aska question about something the childdid that day and have the parent listenwithout interruption or distraction.

l The child needs to have five minutesof the parent’s undivided attentionduring the visit.



Through visits, the conflict between theparent’s passivity and the child’s needs canbe explored and, if necessary, the parent canbe helped to see that treatment for depres-sion would make it possible to meet his/herchildren's needs more effectively.

Example: Visits to Help a Parent Under-stand his/her Child’s Timeframe

Coaching during visits provides an opportu-nity to teach parents about the developmen-tal timeframe of their children. Parents canbe helped to understand that a child’s attach-ment to the foster parent increases the longerhe/she is in care, that there are risks ofmoving children (even back home) at cer-tain ages, and that older children need tohave a resolution of where they will live.The coach helps the parent recognize thatwhile the child will always be seen by theparent as his/her child, the younger the childis the more quickly the individual providingdaily caretaking will become his/her pri-mary attachment. If a parent understandsthe child’s timeframe, he/she may be moti-vated to participate in intensive services tochange in order to meet the child’s needssooner.

Example: Visits to Help a Family Dividedby Conflict

Most of the time, kinship placements allowthe removed child to be in a familiar envi-ronment with flexible, natural visits. But,sometimes the child will become caughtbetween feuding relatives, and in these casesmediation regarding the use of visits to meetthe child’s needs can be effective. The coachserves the dual purpose of mediating be-tween family members and assisting familymembers to understand the needs of thechild and meet them during visits. A mother,for example, initially may not want to be-lieve that her child needs a continuing rela-tionship with the father, or an aunt may wantto keep the child away from her substance-abusing sister (the mother). These individu-als must be helped to see: (1) it hurts thechild to be separated from a family memberto whom he/she is attached; and (2) visitscan be set up to protect the child.

Feuding family members often do not un-derstand that it is a non-optional need of the

child to be able to love both of them and notbe caught in a loyalty conflict. The coachhelps them understand that to meet the child’sneeds they must reduce their conflict andprotect the child from their disagreements.It is an important need of children for theirown identity development to value thestrengths of individuals they are attached to,so the coach must help the relatives under-stand that talking negatively about eachother to the child must stop. The mediator/coach helps feuding family members learnto manage their feelings toward each otherso they can effectively co-parent the child.

III. PROPOSAL FOR A VISIT PRO-GRAM

Visit Support During the First MonthAfter Removal

In many child welfare systems, the first visitafter the child’s placement in foster care isdelayed for weeks because of the worker’soverloaded schedule and the difficulties ofcontacting the parent and of getting thefoster parent or case aide to transport thechild. This delay is harmful to the childemotionally and alienates the parents, re-ducing the likelihood that they will trust theworker or participate in services.12 Untilseveral visits have occurred, it will be diffi-cult to assess what assistance the parentrequires during visits, so delayed initial vis-its may mean that individualized visit sup-port is not be developed for months.

This problem can be addressed by designat-ing a staff person, transportation, and avisiting space to be available just for fami-lies during the first weeks after their chil-dren have been placed. The agency candesignate the same day every week and thesame place for initial visits, so when thechild is removed the parent can be informedof that day for a first visit; thus, the first visitwill always be within a week of removal.There must be a visit specialist and a trans-porter available from 10:00 a.m.-7:00 p.m.on the designated visit day; the visit special-ist will have to work on other days to meetwith caseworkers. The visit specialist andtransporter can be agency employees, con-tractors or volunteers.

As soon as a child is removed, the worker

will notify the visit specialist of the addressand phone number of the child’s placement,the phone number of the parent, and the dateof removal. The visit specialist will sched-ule the transporter to bring the child to thevisit and notify the foster parent of theplanned visit. The visit specialist will callthe parent to confirm the visit time andplace, set up a time to meet during the hourbefore the visit, and identify barriers tovisits—if transportation is a major problemthe worker may offer bus tokens or cab fareor consider having the transporter pick upthe parent as well as the child.

Prior to the first visit, the worker will meetwith the visit specialist to convey the child’sneeds that were identified at the time ofremoval; then, they will develop a specificlist of needs to be met during initial visits.Before the first visit, the visitation specialistwill also call the foster parents to get theirinput regarding the impact of separation onthe child and the child’s behaviors in orderto refine the list of needs to be met in visits.

For each visit during the first month afterremoval, the visit specialist will:

l Meet with the parent before the visitto help him/her anticipate his/her ownand the child’s reactions during thevisit, and to discuss the needs to bemet during the visit.

l Be available to assist the parent asnecessary during the visit.

l Meet with the parent after the visit todiscuss how the parent met the child’sneeds and to plan any changes in thenext visit, including revising thechild’s needs list; and help the parentunderstand the importance of keepinghis/her promise to the child to visit (ifthe parent misses a visit, special ar-rangements to accommodate him/hermust be discussed).

l Call the foster parent after the visit tohelp him/her anticipate the child’s re-action to the visit.

l Prepare notes about the parent’s skillin meeting the child’s needs duringthe visit, including proposing a re-fined needs list.

The visit specialist should have some re-sources to purchase games, toys, and food asnecessary to facilitate visits.



If the visit specialist identifies a case inwhich special arrangements should be madeduring the initial visit phase—such as achild in the hospital, an infant requiringdaily visitation, a parent in residential treat-ment, or a parent who cannot visit on thedesignated day—the visit specialist will pro-pose such an arrangement and who willprovide parent support, and arrange it ifapproved by the worker.

The visit specialist will meet monthly withthe CPS unit to keep them aware of how theinitial visit process is working and to presentchallenging visit cases for discussion.

Whether an office has an average of onechild or five children a month entering fos-ter care, the cost of a visit specialist andtransporter assigned one day a week forvisits for recently removed children mayseem excessive. However, the improvedoutcomes in these cases—including the in-creased attendance of parents in visits, thedesign of individualized intensive visit sup-ports to lead to reunification and shortenedlength of foster care, and the reduced ten-sion between the parents and agency—willmake initial visit support pay for itself.

Supported Visits After the First Month inCare

By the end of the first month of initial visits,the visit specialist and the worker will ar-range a transition to regular visits by:

l Clarifying the needs to be met duringfuture visits.

l Deciding on special arrangements forvisits, including holding them in thefamily’s home, in a relative’s home,in the foster home, at school or atother community locations (visits willbe more successful if they occur in thefamily’s natural environment); andrecommending whether visits shouldbe supervised (supervision is not nec-essary if the risk of harm to the childin visits is minimal).

l Identifying the level of support theparent requires during visits to meetthe child’s needs (and suggesting whomight replace the visitation specialistin the future).

l Arranging for future transportation

depending on the location of visitsand provider of visit support.

Effective coaching during visits will requirea provider who (1) understands the child’sneeds; (2) can supportively remind the par-ent that he/she wants to meet particularneeds during a visit; (3) appreciates theparent’s strengths in responding to the childand builds on the parent’s skills; (4) sets upvisiting conditions to allow the parent toimprove his/her responsiveness; and (5) rec-ognizes improvement. Visit support will bemost effective when it adheres to the prin-ciples listed on pages 11-12.

When designing individualized visit sup-port, it must be recognized that parents havea wide range of needs: some parents requireassistance understanding their children’sneeds (including permanency needs), somemust work on technique-building (such asinfant care or non-punitive limit-setting),some must focus on how to manage theirown needs while responding to their chil-dren, and some need to develop a view of thechild as a separate person whose behaviorcan be influenced by the parent’s actions.These diverse areas of parent support re-quire different skills.

As mentioned earlier, a variety of individu-als might assist with visitation, includingcase aides, foster parents, parenting skillsinstructors, school counselors, therapists,and the parent’s domestic violence or sub-stance abuse counselors. A group of theseindividuals should initially be convened fortraining on visit support. They will thenmeet monthly as a group with a clinicalsupervisor to present their cases and receivehelp on how to provide improved supportduring visits. The clinical supervisor mayrecommend that a different individual workwith a particular family if the visit supportappears insufficient. For example, initially acase aide might work on feeding skills withthe immature mother of an infant who wasremoved for failure to thrive; the parentmight be familiarized with the feeding sched-ule and quantities of formula fed in eachfeeding at the foster home. After severalvisits, the case aide might report at clinicalsupervision that the mother understood feed-ing but seemed depressed and not bonded tothe infant. The supervisor may recommend

that a therapist in the visit support groupwork with the mother during and outside ofvisits because depression, rather than lackof skill at feeding, may be what puts thechild at risk. A goal of the supervision willbe to ensure that all the individuals provid-ing visit support—regardless of their pro-fession—adhere to the visit principles.

For each visit, the visit supporter will:

l Meet with the parent before the visit.l Coach the parent during the visit, in-

cluding hands-on guidance.l Discuss the visit with the parent after-

wards.l Plan the next visit.l Call the foster parent after the visit.l Provide evaluative notes on how the

parent did in meeting the child’s needsduring the visit, and this informationshould be provided regularly to othermembers of the team working withthe child and family.

Supported visits should occur at least once aweek, and more frequent visits will providemore opportunities to change parenting prac-tices that do not meet the child’s needs.Parents should be encouraged to visit con-sistently and accommodations should bemade to facilitate this if a parent is missingvisits.

Visits should occur in the location mostaccessible to the family and the visit sup-porter will travel to that location. The visitsupporter cannot transport the child to andfrom the visits unless child care is providedduring, before and after discussions betweenthe visit supporter and parent. If the visitsupporter is the child’s foster parent, some-one must provide child care for other chil-dren in that home and for the child prior toand after visits so the foster parent can workwith the parent.

If a case moves from a protective serviceunit to a continuing service/foster care unit,the individual providing visit support wouldparticipate in the transition meeting (wherethe needs to be met during visits will bediscussed) and continue to work with theparent after case transfer.



Transition to Reunification Supports

Reunification is based in part on the familyshowing an understanding of the child’sneeds and meeting those identified needs invisits. The experience of the parents, child,worker and individual providing visit sup-port will inform the design of reunificationservices.13

It is expected that (1) time between theparent and child will increase as reunifica-tion begins, including weekend day andovernight visits; (2) the visit supporter willplan reunification with the worker, family,foster parent and other providers; (3) thevisit supporter will continue to assist thefamily as they spend more and more timewith the child in the home; and (4) the visitsupporter will coach extended family orsomeone positive in the family’s environ-ment on how to support the parent infor-mally when the child is in the home.14

Instead of reunification being a separateservice, when the visit supporter can be-come the reunifier, a smoother transitionand more effective meeting of the child'sneeds are likely.

Transition to Planning for Another Per-manent Home

If supports are provided to parents duringvisits and over time the family does notunderstand the child’s needs and/or is notable to meet those needs in visits despiteservices, visits can be used to help the fam-ily recognize that the child’s needs would bebetter met in another permanent home. Thefamily will be involved in planning thatother permanent home and what needs, ifany, can be met by the family in the future.For example, in the case of a 6-month oldchild who was removed from her mother ata homeless shelter, the mother was initiallyengaged in frequent visits to support theirattachment. But, after the mother was hospi-talized for depression several times and shewas not well enough to visit much for ninemonths, she had to be helped to understandthat (1) her continuing depression was mak-ing it difficult to concentrate on her child'sneeds; (2) her child’s attachment to thefoster mother was getting stronger; and (3)developmentally her child could not main-

tain the concept of “two mommies.” Visitsupport was provided when the mother wasout of the hospital, and was used effectivelyto help the mother recognize the child’sneed for permanency and plan for adoptionby the foster family.

When reunification is not the goal, visits canstill be a way to meet the child’s needs. Evenwhen only intermittent contact between par-ents and children occurs, biological parentscontinue to be significant in a child’s devel-opment.15 The biological family is the sourceof identity for a child. What a child knowsand imagines about the biological familyhelps to mold the child’s self-perception,and failing to come to terms with the lifelineto the biological family ultimately may causefoster care and adoption to break down. It isessential for everyone in the child’s life toagree about the child’s connection to thebiological family and what needs the bio-logical family can meet, in part in order tostabilize the child's permanent placement.

Support for Foster Parents

Visit support is also important for fosterparents. It is crucial to help the foster parentmanage the disruption of the householdroutine caused by dealing with the child’sreactions to visits. Giving the foster parentthe opportunity to express his/her frustra-tion and talk about the child’s reactions toseparation can be valuable.

__________________

Endnotes

1. Researchers have found that more frequent parent-childvisitation is associated with shorter placements in fostercare (MaryEllen White, Eric Albers, and Christine Bitonti,"Factors in Length of Foster Care: Worker Activities andParent-Child Visitation," in 23 Journal of Sociology andSocial Welfare, 1996, pp. 75-84; Edmund Mech, "ParentalVisiting and Foster Placement," in 22 Journal of ClinicalChild Psychology , 1993, pp. 67-72; David Fanshel andEugene Shinn, Children in Foster Care: A LongitudinalInvestigation, New York: Columbia University Press,1978). Increased social worker contact with parents ofchildren in care is associated with more frequent parentalvisitation and ultimately with a shorter time in placement(White et al, 1996; M. Benedict and R. White, "FactorsAssociated with Foster Care Length," in 70 Child Welfare,1991, pp. 45-58; T. Gibson, G. Tracy, and M. DeBord, "AnAnalysis of Variables Affecting Length of Stay in FosterCare," in 6 Children and Youth Services Review, 1984, pp.135-145; J. Turner, "Reuniting Children in Foster Carewith their Biological Parents," in 29 Social Work, 1984, pp.501-505). When workers did not encourage parents to visitor use visit locations other than the agency office or engagein problem-solving with parents, children tended to remain

in foster care 20 months or more (White et al, 1996;Fanshel and Shinn, 1978; Anthony Maluccio and EdithFein, “Growing Up in Foster Care,” in 7 Children andYouth Services Review, 1985, pp. 123-134).

2. The context of the visit approach presented in this article isstrengths/needs-based child welfare practice, which isdescribed in my article in the Fall 1997 Prevention Report.Strengths/needs-based child welfare practice emphasizesforming a collaborative relationship with families andfocusing on children’s needs as a strategy for involvingfamilies in actively designing the services they will partici-pate in to support their meeting those needs.

3. Children's reactions to separation have been well-docu-mented in divorce research: "More than half the youngsterswere openly tearful, moody, and pervasively sad. One-third or more showed a variety of acute depressive symp-toms, including sleeplessness, restlessness, difficulty inconcentrating, deep sighing, feelings of emptiness, playinhibition, compulsive overeating . . ." (p. 47). "Over-whelmed by their anxiety, very young children returned totheir security blankets, to recently outgrown toys. Lapsesin toilet training and increased masturbatory activity werenoted . . ." (pp. 57-58). Judith Wallerstein and Joan Kelly,Surviving the Breakup, New York: Basic Books, 1980.

4. Paul Steinhauer, The Least Detrimental Alternative ,Toronto: University of Toronto Press, 1991.

5. Richard Barnum, "Understanding Controversies in Visita-tion," in 26 Journal of the American Academy of Child andAdolescent Psychiatry, 1987, pp. 788-792.

6. Ibid, p. 791.7. Rutter 1978 qtd. in Charles Horejski, Anne Bertsche, and

Frank Clark, Social Work Practice with Parents of Chil-dren in Foster Care, Springfield, Ill.: Thomas, 1981, pp. 5-6.

8. Barnum, p. 788.9. Joan Grusec and Jacqueline Goodnow, "Impact of Parental

Discipline Methods on the Child's Internalization of Val-ues," in 30 Developmental Psychology, 1994, pp. 4-19.

10. Ibid, p. 17.11. D. Baumrind, "Current Patterns of Parental Authority," in

4 Developmental Psychology Monographs (No. 1, Part 2),1971.

12. "Most parents who were scheduled to visit did so, and mostvisited in compliance with the schedule specified in thecase plan. Parents who did not have a visiting schedule orwho were told to request a visit when they wanted one didnot visit. This clearly suggests that a way to increase thefrequency of visits is to schedule them to occur morefrequently" (p. 180). Kathleen Proch and Jeanne Howard,"Parental Visiting of Children in Foster Care," in SocialWork, May-June, 1986, pp.178-181.

13. For further information on reunification see: P. Carlo,“Parent Education vs. Parent Involvement: Which Type ofEfforts Work Best to Reunify Families?” in 17 Journal ofSocial Service Research , 1993, pp. 135-150; Edith Feinand I. Staf, “Last Best Chance: Findings from a Reunifica-tion Services Program,” in LXXII Child Welfare, 1993, pp.25-40; P.M. Hess, G. Falaron, and A.B. Jefferson, “Effec-tiveness of Family Reunification Services,” in 37 SocialWork, 1992, pp. 304-311; Anthony Maluccio, Robin Warsh,and Barbara Pine, “Rethinking Family Reunification afterFoster Care,” in 5 Community Alternatives, 1993, pp. 1-17;B.A. Pine, R. Warsh, and A. Maluccio (eds.), TogetherAgain: Family Reunification in Foster Care, Child Wel-fare League of America, 1993.

14. C.J. Dunst, C.M. Trivette, and A.G. Deal, Enabling andEmpowering Families, Cambridge, MA: Brookline Books,1988.

15. Margaret Beyer and Wallace Mlyniec, “Lifelines to Bio-logical Parents: Their Effect on Termination of ParentalRights and Permanence,” in 20 Family Law Quarterly,1986, pp. 233-254.



Parent-Child Visits as an Opportunity for Change:Visit Principles

by: Marty Beyer, Ph.D.

1. PARENTS WILL BE SUPPORTED TO MEET SPECIFIC INDI-VIDUAL NEEDS OF THEIR CHILDREN DURING VISITS.

n The child’s needs that are identified to be metduring visits will be logically connected to thereasons the child was removed from home. Theywill be related to the safety, attachment (includingpermanency), and developmental needs which mustbe met for reunification to begin.

n Parents’ knowledge about their children’s needswill be respected and parents will participate indefining the needs to be met during visits.

n Learning about their children’s non-optional needsmay be the first goal of visit support for someparents.

2. PARENTS WILL BE SUPPORTED TO LEARN THAT THEIR

CHILDREN’S BEHAVIOR IS SHAPED BY THE PARENT’SWORDS, ACTIONS AND ATTITUDES.

n Parents will be helped to shift away from viewinga child’s behavior as inherent to the child’s charac-ter (e.g., “he’s bad,” “she’s withdrawn,” “he’shyper,” “she’s seductive”); this may be amultigenerationally held view.

n Parents will be helped to improve the fit betweentheir discipline approach and their children’s de-velopmental levels, temperaments and misbehav-ior. They will be helped to see the effect on thechild of the parent being too controlling or toopassive. Particular attention will be paid to howparents can reduce aggressive and sexual behaviorby their children. The parent will be helped tounderstand limit-setting and responsibility that fitthe individual child’s developmental level.

3. SUPPORT FOR PARENTS IN VISITS WILL BUILD ON THEIRUNIQUE STRENGTHS.

n The approach to parent support during visits willconvey a belief that the parent wants what is bestfor the child.

n Parent support will be individually designed to fitthe parent’s capacities and cognitive style.

n Those involved in visit support will actively lookfor improvement and reinforce it.

n Parent support will be designed specifically toempower the parent, both during visits and in thefuture if he/she resumes caring for the child.

n Those involved in visit support will maintain ahopeful focus on meeting children’s needs and willreframe the parent’s discouragement.

n Those involved in visit support will actively avoidnegative references about parents, in and outsidethe parent's presence.

4. SUPPORT FOR PARENTS BEFORE, DURING AND AFTER

VISITS WILL BE CONCRETE, TARGETING SPECIFIC

PARENTING BEHAVIORS.

n Parents will be helped to clarify their children’sneeds before the visit and stay focused on themduring the visit. Parents will be helped to under-stand how their own needs get in the way of seeingand meeting their children’s needs at visits.

n Parents will be helped to anticipate their children’sambivalent feelings about the visit and not to behurt by these.

n Parents will be helped to manage situations wherethey perceive their children as too demanding.

n Parents will be recognized when they show empa-thy for their children.

n Parents will be helped to respect their children asseparate people.

n Parents will be helped to adjust their parenting tothe different needs of each of their children.

n Parents will be helped to see how their anger orfeeling chronically victimized get in the way ofmeeting their children’s needs.

n Parents will be helped to understand their ownambivalence about visits. Parents will be helpednot to use visits as a place to fight with theircaseworker or others—both to deal with theirfeelings toward professionals and extended family



outside of visits and to recognize how their fight-ing is a way to handle their ambivalence aboutvisits.

5. THE MORE OFTEN AND CONSISTENTLY VISITS OCCUR,THE MORE QUICKLY THE PARENT WILL MAKE PROGRESS.

n Visits should occur as often as necessary to meetthe particular child’s needs. Meeting the needs ofmost children will mean visits starting within aweek of removal.

n Supported visits should occur at least once a week.More frequent visits provide more learning oppor-tunities and feedback to change parenting habitsthat do not meet the child’s needs.

n Those involved in visit support will convey howessential consistent visits are, not only for the childbut also for the parent to demonstrate that he/shecan meet needs so reunification can begin.

n Visits should be convenient for the family. Any-time a parent misses a visit will be seen as anindication that the parent is not satisfied withvisits, and accommodations will be made.

n It is usually harmful for children not to visit theirfamily. The child’s attachment to each parent willbe appreciated (independent of the harm inflictedin the past) as the basis for decisions about visits.Then the child must be supported in whateverways meet the child’s needs.

6. SUPPORT FOR PARENTS TO MEET THEIR CHILDREN’SNEEDS SHOULD OCCUR AS MUCH AS POSSIBLE IN THE

FAMILY’S NATURAL ENVIRONMENT.

n As soon as possible, visits should occur in thefamily’s home, relative’s home, or communitysetting and involve extended family and interac-tion with school, church and the neighborhood.

n Standards for supervised visits should be carefullyassessed—supervision is not necessary if the risk ofharm to the child in visits is minimal.

n Strategic involvement of the extended family invisits will enable them to support the parent inapplying what they learn about meeting the child’sneeds to everyday situations if the child returnshome.

n Those involved in visit support will encourage thefamily’s self-sufficiency. Parent support should bedesigned to achieve lasting change, not be time orsituation limited.

7. SUPPORT FOR FOSTER PARENTS BEFORE AND AFTER

VISITS WILL HELP THEM UNDERSTAND THE CHILDREN’SBEHAVIOR AND NOT BLAME THE PARENTS OR CHIL-DREN.

n Support will be designed for foster parents tounderstand children’s needs before, during andafter visits.

n Foster parents will be helped to understand whatchildren are communicating by difficult behaviorsbefore and after visits.

n Foster parents will be helped to understand thebenefits of visits to children, even if a child hasbehavior problems after visits.

8. VISIT SUPPORT WILL BE FREQUENTLY EVALUATED.

n All the individuals working with a child and fam-ily will meet regularly, discuss the parent’s progressin meeting the child’s needs in visits, and makechanges accordingly. Questions to consider in-clude: “Is the parent meeting the child’s needsduring visits?” “If not, what should change aboutvisits?” “Is the list of the child’s needs inaccurate?”“Are there underlying causes of the parent notmeeting the child’s needs that have not been ad-dressed through support?”


A Learning ExchangeBuilding Neighborhood Place: Lessons Learned Through Developing a NewHuman Service Delivery System

by: Martin BellDeputy Superintendent, Community Development, Jefferson County Public Schools, Louisville, Kentucky

It is widely recognized that the current hu-man service delivery system is inadequateand fragmented. With seemingly little re-gard for families and individuals, humanservices are located at separate sites, requireduplicative paperwork and, in the end, offeronly a costly band-aid. The process of seek-ing services is, at best, frustrating, and manytimes even dehumanizing.

Recognizing this inadequacy, major health,human service and education providers inJefferson County, Kentucky made a com-mitment to create a system of services that ismore supportive of and responsive to fami-lies and individuals. This commitmentevolved into the creation of a series of Neigh-borhood Place centers, each of which offersa wide array of services that are accessible,family friendly, and results oriented. Thesecenters embody the concepts of collabora-tion and integration of services to a pointbeyond any other project based on the sameprinciples.

The Neighborhood Place concept grew outof a collaborative group that was formed byJefferson County Public Schools in 1991,after the state passed a reform act that in-volved creating Family Resource/Youth Ser-vices Centers in the schools. As deputysuperintendent of the schools, I was in-volved with this collaborative process fromthe beginning. The centers were to serve asinitial referral points for families or youth inneed of health or human services; but, sincewe were in a heavily populated urban set-ting, there was a fear the agencies would beoverwhelmed with referrals. The parties in-volved were brought together to discusshow we could make this system work better.Initially, we developed the idea of using thenew state resource to hire only one coordi-nator to oversee a number of centers (ratherthan having one for each) and then hiringother staff, such as a nurse and/or mentalhealth provider, who could rotate among

centers and provide services right at theschools. When the state refused this pro-posal, this motivated us to think of a differ-ent way to move services closer to the schoolsand families and make them more conve-nient.

Over the next two years, the idea evolved ofcollecting staff and services of a variety ofagencies in accessible centers (which weregiven the name Neighborhood Place centersby the staff of the first site) that were to bebuilt on a shared vision including the fol-lowing:

t All residents of Jefferson County willeventually be served by one of eightregionally located Neighborhood Placecenters.

t The size and constellation of serviceswill vary from center to center accordingto the needs and scope of the existingservice network of the neighborhood.

t The core services at each NeighborhoodPlace will include health, mental health,and child and adult welfare services.

t Providers of these core services will sharea commitment to prevention, commu-nity education and family self-suffi-ciency.

This concept was worked out through col-laborative meetings of the group, whichwere initially held monthly, then weekly aswe neared the actual development of thefirst site. It was decided that every organiza-tion must commit to put staff at all eight ofthe sites in order to participate. Seven orga-nizations made this commitment; in addi-tion to the school system (which offers edu-cational services and school attendance sup-port), the partners and services providedinclude: the Department for Social Insur-ance (welfare services), the Department for

Social Services (child protective services),the Department of Health (health care ser-vices), Jefferson County Government (emer-gency financial assistance and family out-reach), City Government (youth program-ming and youth initiatives), and SevenCounty Services (mental health and drugand alcohol treatment).

The first Neighborhood Place center openedin the fall of 1993 in some excess space inone of the school system’s buildings, with acoordinator provided by County Govern-ment and roughly twenty-six staff membersrepresentative of all of the participating or-ganizations. There are currently seven fullyoperational centers, all funded by the part-ners. Each center has a distinctive localflavor, but they have these common featuresthat highlight the uniqueness of the Neigh-borhood Place concept:

A Single Intake and Assessment Process:The intake and assessment process is drivenby the simple goal that no client will beasked to repeat a piece of information. Theclient/customer may be required to giveadditional information or to verify some ofthe information provided, but at the point ofintake the worker tries to collect all theinformation that he/she and other workers atthe center will need. Thirty-six data ele-ments needed by staff from all the agencieshave been identified, and during intake aworker inputs these into a shared computersystem. This goes beyond mere co-locationof agencies. The single point of intake al-lows a worker to identify and tell the clientabout a variety of resources at the center thatmight be useful to him/her in addition to thespecific reason for coming in, and then coor-dinate needed services with the other work-ers. As a result, many clients/families canbegin to establish numerous goals at thepoint of entry.

neighborhood place______________________________________________________________________



Common Release Form: A second featureis the common “Consent to Release Infor-mation” form. After months of difficult pro-cess, all the agencies involved with Neigh-borhood Place agreed to have workers at thecenters abide by the single consent formnow used. This allows the workers to com-municate, within the laws, regarding thegoals, plans, and progress of a client/familyand to have the workers, not the client, makethe necessary adaptations to facilitate coor-dination of services. One of the main ben-efits of this approach is apparent at times ofcrisis. When a crisis occurs, the client hasaccess to a number of professionals who arein a position to assist or support, rather thanhaving to wait until a specific staff person isavailable.

Team Approach: A third benefit of theNeighborhood Place concept is that theworkers are involved in a unified effort toachieve specific goals, even when the goalsare not specific to a client. It is not uncom-mon for workers in a variety of agencies tocollaborate relative to a particular client.However, Neighborhood Place allows work-ers to select and design ways they can en-hance each other’s functions through a teameffort. The workers are aware of and under-stand the services that workers from all theother agencies offer, and try to make surefamilies have access to them. For example,a family may come in for emergency finan-cial assistance. If the worker offering thisnotices on the application that the parentshave children, he/she might ask how thechildren are doing in school and, if there areproblems, try to involve them with a workerfrom the school system.

This concept goes well beyond decentrali-zation. It is a model in which communica-tion between service providers occurs be-fore the various workers engage in an activ-ity. Therefore workers are able to set priori-ties with a clear understanding of their col-leagues’ activities, which significantly re-duces duplication or counter-productivity.

Community Focus: A fourth feature ofNeighborhood Place that contributes to itsuniqueness is that the program targets thetotal population. Other programs and agen-cies have had great success when targeting aspecific small group; for example, an agegroup—such as an age group in a school orin a building in a housing project. Based onthese successes, Neighborhood Place hasbroadened the target population of each cen-ter to a relatively large geographic area.(What we still need to identify is the stan-dard for optimum ratios between populationand services.)

New Delivery Model: Neighborhood Placeis not just a new program—it is a new way ofdelivering services. The uniqueness andstrength is that agencies are not competingwith each other and are in a position tomaximize every resource available to them.What is of benefit to the client and to Neigh-borhood Place service sites is also a benefitto participating agencies.

Each Neighborhood Place center is a hugeendeavor; rather than just pulling togetherfunds and hiring new people, it requirestaking existing staff members from theircurrent work locations, putting them to-gether in a new environment with workersfrom other agencies, and asking them tocontinue to do their own business as well aswork in an effective team.

Although no formal system of governancewas established until several NeighborhoodPlace centers had been opened, a three-levelsystem eventually evolved. Currently, eachNeighborhood Place has a community coun-cil made up of citizens who live in thecommunity, and perhaps some representa-tives from nonprofit organizations workingthere, who give direction and input on howthe center works for them. An operationscommittee is made up of policymaking indi-viduals from each of the organizations, my-

self included, who meet weekly to deal withissues relating to each of the agencies andengage in “knocking down barriers” to thecollaborative effort. The managing board isthe policymaking body and it includes onerepresentative from each of the partners andone from each community council.

LESSONS LEARNED

During the process of taking NeighborhoodPlace from a concept to an operating reality,there were good times and less-than-goodtimes. Stepping back from this very dy-namic development process, there are les-sons learned that may be beneficial to othersinvolved in or considering a similar collabo-rative effort. Following are one participant’sreflections on eleven lessons learned:

The first lesson learned may seem obvious,but all parties involved in the collaborationmust agree on why they are there. They mustanswer the question “What is the vision/mission?” Early on, we developed our mis-sion statement: “Neighborhood Place workswith communities to provide blended andaccessible health, education, employment,and human services that support childrenand families in their progress toward self-sufficiency.” The mission statement empha-sized health, education, and human services;and focused on families, children and self-sufficiency. We recognized that we cannotbe all things to all people—and this wasquickly reinforced by experience.

For a period of time, we were unfocused andwere attempting to change all human ser-vices, a task that was outside why we werereally at the table. This temporary abandon-ment of our mission caused an upheaval inall the human services arenas and caused usto experience a less-than-productive exer-cise in damage control.

We had to remember that we are not aboutsenior citizens, we are not about agenciesthat are not at the table, and we are not aboutchanging all human services. The lesson—agreeing why you are there and stayingfocused on why you are there—is an easyone to overlook and, thus, can cause theparties to get mired down in what they arenot trying to accomplish.

"Neighborhood Place is not justa new program—it is a new way

of delivering services. Theuniqueness and strength is thatagencies are not competing witheach other and are in a position

to maximize every resourceavailable to them."



A second extremely important lesson is tohave the decision makers/policymakers fromparticipating organizations at the table. Thisdoes not mean the CEO; the CEO is anenabler who gives key policymakers in anorganization the leeway to make changehappen.

The decision makers to whom I refer are thetop operational people in the organization—people who can identify and commit re-sources (staff and finance). In our experi-ence, these are the individuals who report tothe CEO and have experience working acrossthe organization. They are not interested indetails but are vested in the vision and willprovide support to the people who will payattention to details, and they can motivatedepartments not already committed to theprogram.

The third lesson is that the people involvedin the collaborative effort have to shed theirtitles and their personal interests, especiallywhen involved in meetings. This means,while at the table, I am not deputy “blank” orexecutive vice president of “blank,” etc. Iam part of the team. It also means I am not“Mr. or Ms. Health Services,” or “Mr. or Ms.Schools,” or “Mr. or Ms. Human Services.”Again, it means I am part of the team.

No one should pull the “my organizationneeds or wants” trick at the table. If theagenda diverts to one organization’s or oneperson’s agenda, the collaboration will diebecause the others will lose their commit-ment. The table needs to be round, seating agroup of individuals with resources behindthem who are working jointly to accomplishthe common agenda—the mission. Partici-pants must leave the egos, the titles, and theirrespective organizations at the door.

Lesson four is to put off the issue of gover-nance structure (how to oversee the organi-zation) until the organization is matureenough to handle it. I have participated inmany partnerships, collaborations, and com-mittees where much of the initial energy wasspent on trying to decide who was in chargeand how to decide who was in charge. Gov-ernance, bylaws, and contracts can divertenergy away from what needs to be accom-plished.

During the initial planning of NeighborhoodPlace, we discussed governance often andseveral ideas were considered and rejected.Fortunately, we were committed enough toour joint program that we had the vision toset governance aside and not let it tie us up.If we had adopted the governance structureof some of our earlier operations that wereconsidered, I do not believe we would havesurvived and been able to open our Neigh-borhood Place centers.

Rather than becoming preoccupied withgovernance, we operated many years—andopened many centers—through meetingswith no formal leadership where representa-tives from all the organizations cooperatedto make decisions. You will probably find,as we did, that after experiencing the exhila-ration of early successes programmatically,participants learn one another’s idiosyncra-sies and form a real, committed team. Aftera viable team is formed, governance be-comes just a business responsibility, not amake-or-break threshold proposition.

Creating a sense of accountability among allinvolved is the fifth very important lesson.The CEOs and community expect any majorendeavor to be more than a “feel good”exercise. There is a wise saying that puts itthis way: “You get what you measure.” Putdifferently, it means that those working onand in the project will focus on what is beingmeasured.

It is important that all participating agenciesidentify with the measurements to be usedfor the accountability system. For example,we started off with customer satisfaction (asmeasured by surveying) and school atten-

dance of children in the area as our initialaccountability measures. All partners sawthese measures as important for the commu-nity and for Neighborhood Place, and eachsaw that it could become a full participant inachieving success. The CEOs, whether ap-pointed or elected, could speak about themto their boards with confidence.

An obvious lesson that applies to life ingeneral is lesson six: Learn from your fail-ures. If you don’t, failures can turn organiza-tions inward and away from the joint mis-sion. For example, when the state gave anemphatic “NO” to our early proposal re-garding the Family Resource/Youth Ser-vices Centers, it would have been an excel-lent opportunity to fold our tents and go ourseparate ways. However, instead it causedus to rethink our strategy and use our re-sources to accomplish the general strategy adifferent way.

A second example of learning by our mis-takes occurred when a large foundation askedus to consider working with it to demon-strate improved services through the use ofgreatly enhanced technology. Our mistakewas letting the work to please the foundationconsume our energy and divert our work onNeighborhood Place. The funding fellthrough, but the experience forced us torecognize the technology challenge and toput our own resources into that effort. Wealso learned not to get diverted by grants andfunding proposals.

That leads us nicely to the seventh lesson:Infrastructure is important. In our case, thatmeans a technology system that works acrossall agencies is critical to the long-term suc-cess of the collaboration. If the collabora-tion increases the workload, staff will sup-port the extra effort for a period of time dueto a commitment to wanting to do thingsbetter. Eventually, however, the novelty willwear off and extra work can become theexcuse for not wanting to address families’needs. Good technology that allows staffmembers at the centers to work with theiragencies and with each other can addresspaperwork barriers to effective collabora-tion. Put a group together that will work onthis infrastructure need soon after the mis-sion has been developed. This can be a slowbut essential process.

"During the process of takingNeighborhood Place from a con-cept to an operating reality, therewere good times and less-than-good times. Stepping back fromthis very dynamic developmentprocess, there are lesssons learnedthat may be beneficial to othersinvolved in or considering a simi-lar collaborative effort."



Lesson eight is easy to take for granted, butthose involved with the effort need trainingto make it work. The bigger the effort, themore training is needed. Training bringscommon vision, understanding of commonproblems, and a commitment to be part ofthe team to help the collaboration work.

We find it useful to:

t Train the staff members involved withcross-agency participation. This helpsthem better understand the services work-ers from other agencies offer, and en-hances their ability to work together.

t Train the mid-level managers at eachparticipating agency with those from theother agencies at a single session.

t Train the community leaders who areinvolved in the community councils.

Be committed to training. Shut down ser-vices and provide training on a regular week-day to clearly communicate to everyone thelevel of commitment to jointly trained staff.

Lesson nine already has been implied, but itis important to view it as a separate lesson:Do not get drawn off your mission.

Since we are deeply involved in health andhuman services, we were drawn into thewelfare reform effort, a state plan for com-munity collaboration, an empowerment zoneapplication, and a foundation plan to re-structure human services. It is important tobe vigilant, supportive, and cooperative withsuch efforts, but such endeavors can reducethe ability of the collaboration to stay fo-cused on the mission and to move toward itstotal implementation.

We are not there yet, but at some point theenergy for change will wane to an opera-tional mode. Too many diversions willshorten the window of opportunity to createtrue change. This is an especially importantissue to the staff implementing the vision.The staff will only ride the roller coaster ofchange for so long. After a period of time,they rightfully will question the commit-ment of leadership to support them in mov-ing to the destination. This is not to imply the

change process is an end process, but theremust be comfort points along the way thatindicate significant accomplishment.

A true collaborative effort requires sustainedhard work—this is lesson ten. If the group isnot committed to hard work, the effort willmost likely have limited success.

Let me illustrate what this may mean toindividuals involved. In our efforts, the op-erations committee meets every Friday for atwo-hour meeting. The effort consumes ap-proximately twenty-five percent of theweekly schedule of the participants. This is,in most cases, in addition to already busyschedules, not instead of some other jobfunction. These types of efforts will add tothe job responsibilities of the initiators, notreduce them. And much of the work is labo-rious problem solving; it takes time andwillingness to “gut out” difficult times. Thereis no one involved in Neighborhood Placewho will say this type of change effort iseasy.

The final lesson, number eleven, is this:Celebrate! Everything described can becomea personal burden too great to carry if thereare not times of celebration. Celebrate withstaff, celebrate with community, celebratewith one another. Celebration by definitiontells everyone that the outcome is worth theeffort.

CONCLUSION

We believe we are reinventing the way wedo business. One could ask how we knowit—try this for an answer:

We just opened a new Neighborhood Placecenter built on School District property,paid for by County Government bonds, fur-nished by the Commonwealth of Kentucky,and staffed by all seven agencies.

We just completed a survey that showsninety-three percent of our customers weresatisfied with our services.

We just experienced an increase in the per-centage of student attendance, the first inseven years.

Most importantly, we have encouraging suc-

cesses with families such as this: A “schooltruant officer” (assistant director of pupilpersonnel) visited a home because of anabsent student and discovered two otherchildren already out of school (dropouts).The truant officer connected the family toNeighborhood Place services that helpedby:

t Remediating spousal abuse;t Assisting the mother to find employ-

ment;t Establishing secure housing;t Returning the two dropouts to school to

graduate; andt Raising the grades of the failing “truant”

to an Honor Roll student.

Celebrate!

________________

A version of this article is also published inthe Proceedings of the American HumaneAssociation Children's Division's First Na-tional Roundtable on Innovative Commu-nity-Based Partnerships.


A Learning ExchangeVoices of Experience: The Work of Building Philadelphia’s Family Centers

Editor's Note: For the greater part of the past decade the city of Philadelphia has been engaged in building a system of CommunityFamily Centers throughout many of the city’s neighborhoods. Sponsored by the Mayor’s “Children’s Cabinet,” the Family Centersbrought family support and prevention services into neighborhoods in a new way, blending conventional health and social services withfamily support and activities to promote family development. This effort required fundamental changes in relationships between people,and within people’s own self-understanding in order to promote a new way of working, a new kind of professionalism. The personalchallenges of systems change (often overlooked) are brought home in these pieces from Keith Sheppard, a community social worker,and Cornelia Swinson, an administrator and community leader of the Lower Germantown Rebuilding Communities project inPhiladelphia.

CHANGE AND CHALLENGE

by: Keith Sheppard, Case Manager forthe Department of Human Services

To be honest, my motivation to become partof the Family Center Initiative was drivenmore by my desire to leave the stress andfrustration of my previous work experiencethan by Family Center philosophy. FamilyCenter goals of strengthening families andultimately building communities soundedgood. But I began my Family Center expe-rience looking for a place to regroup andhopefully regenerate. My Family Center ori-entation period, before being assigned aFamily Center, was just that place for me.Shortly thereafter, however, second thoughtscrept in. As stressful as my previous workexperience had become I at least “knew theropes.” I knew what to expect and I knewhow to respond to a given situation. I wascomfortable with some aspects of my newposition but was unsure if I was ready forwhat I saw as the leadership responsibilities.As coworkers began to be assigned to theirFamily Centers and I was still unassigned,my anxiety level grew.

One of the positive aspects of this newexperience, however, was my relationshipwith my new supervisor. Although I knewwho he was from my previous work experi-ence, I never got to know him. I soon beganto appreciate what he brought to the table interms of his intellect and also his profes-sional and life experience.

Eventually, I was assigned to a Family Cen-ter and was given a mandate not to getinvolved in any of the intra-office turmoilthat was present. I also was informed that theschool’s relationship with the Family Center

was less than productive. As I began toexperience some of these problems it crys-tallized for me the belief that Family Centerscould never achieve what was envisionedwithout Family Center staff being supportsfor each other. Doubt began to surface. Wasthere too much idealism and not enoughpragmatism? Why was communication sopoor? Had there been enough planning be-forehand? I began to focus on what I foundmost comforting, working directly with chil-dren and families. My rewards came solelyfrom these experiences.

Problems at the Family Center persisted andbegan to color my perceptions of the initia-tive as a whole. I tried to help repair relation-ships that continued to deteriorate. Nothingseemed to work. Eventually the result wasan overhaul of staff at the center. At this timea decision was made to select a communitypartner to oversee the operation and devel-opment of the Family Center. My role wouldbe the point person in the selection process.

Other stakeholders who were part of thisprocess were skeptical and I often bore thebrunt of their skepticism. At times I feltisolated and unsupported. This new rolepushed me in directions that were uncom-fortable but I can honestly say that personalgrowth was achieved as a result.

At this time, one of the things occurring forme was that each day I was feeling more andmore a part of the community I was attempt-ing to serve. Every day I was learning thename of a child. Relationships with familieswere becoming stronger. Cultural differ-ences were recognized and appreciated. Itfelt good when a child called my name in theschoolyard or a parent asked for advice.Through my own personal journey within

the Family Center, I could envision what aFamily Center could become to a commu-nity.

Another challenge occurred after the selec-tion of partner agencies. I was optimisticabout the future of the Family Center. Thelead partner agency’s vision and commit-ment were impressive. They were truly com-mitted to the ideal of a community drivenFamily Center. But I was again unclear ofmy role. How would it change? Would thenew staff work in a cooperative and support-ive fashion? Would I be accepted even thoughI wasn’t an employee of the lead partneragency? As new staff was hired and pro-grams started, these questions were soonanswered. My role changed as needed. I didadvocacy and referrals but also tutored chil-dren. I assisted in the supervision of hand-ball and Halloween parties but also gaveinput on programming issues. With eachnew program and activity the Family Centerbecame more significant to the communityit served.

Reflecting back, change and challenge bestdescribe my Family Center experience. Allin all, the changes have been made for thebetter and the challenges have been the basisfor the successes.

SHAPING A NEW RESPONSE TOCHILDREN AND FAMILIES

by: Cornelia Swinson, Vice President forPlanning and Development, GermantownSettlement

Along the Way I Met Some People andWe Decided to Bake a Cake

Early in 1990, I met two women. Little did I

philadelphia's family centers______________________________________________________________


know, nor did they, that both of them wouldend up being involved in the leadership of amovement to create and develop new ap-proaches to support kids and families, rightsmack dab in the middle of neighborhoods.And I would be right in there with them.Even more surprising was the fact that thismovement would be implemented in part-nership with communities and various pub-lic systems representatives across the city ofPhiladelphia. The movement, the creationof Family Centers and the beginning ofFamily Service Systems Reform, wouldposition my agency, and most specificallyme, to be involved at the forefront of one ofthis city’s most exciting opportunities tocome along in a very long time.

I met these women when they came to ouragency to ask us to work with them on aspecial project. The project was intended tohelp create community ownership towardsefforts to improve utilization of and accessto quality health care for children. Follow-ing our meeting, the executive director ofour agency asked me to work on the project.

Right away, I liked these women, one ofwhom was African American and one ofwhom was white. We shared informationabout our work backgrounds, common ex-periences which we felt led us to approachour work with different expectations. Thoseexpectations were aimed at reaching higherand setting a different standard for commu-nity empowerment and capacity building.Almost immediately, I felt a connection andknew that we could do some innovativework together. I was excited about the flex-ibility with which we agreed to approachthis work.

Our relationship started with talk about howbest to connect with the community in arespectful way. I shared with them our fam-ily of agencies’ historic approach to com-munity development: to plan with and forthe community. They followed our lead andagreed to be “introduced” to the communityover a period of time because they werestrangers. We made a difference and weworked well together. We started out with aspecific set of assumptions and goals; weended up with much, much more.

While knocking on doors and being invited

into people’s homes (albeit hesitantly insome cases) we encountered so many issuesimpacting my neighbors. Most of those is-sues centered around a lack of knowledgeabout what was available, the disapproval ofcumbersome rules and regulations surround-ing the delivery of particular programs andservices, the inability of the bureaucracy ofpublic systems to respond to individual fam-ily needs in a personal and timely manner,frustration with the way in which serviceswere duplicated and not coordinated, and . .. well, I think the point is understood.

We fashioned a response to these concernsby picking up bits and pieces from here andthere and linking them where appropriate.We moved many children through varioussystems. In the process of linking kids andfamilies with quality health care, we en-countered, navigated and delivered responsesto requests for assistance in other areas,including housing, energy, youth services,jobs, child care, recreation and much more.

One community volunteer hung in there likeshe was getting paid—she was not and nei-ther was I. Little did we know then that whenwe implemented the Family Center we woulddecide that people like her were the best andmost appropriate persons to be Family Cen-ter Specialists—and she is.

Slowly our thoughts began to evolve; webegan to ask ourselves if this was the way togo. We quickly came to the conclusion thatin order to improve the community you hadto do it piece by piece, you had to know it totake care of it, you had to be there to see andfeel it, you had to take it personally, and youhad to take care of business. Imagine, we didthis on a shoestring budget, a strong com-mitment, incredible resiliency, and just plainold determination.

The years went past . . . 1990, 1991, 1992,1993. What would happen if we could reallydo this in a significant way? We just won-dered with a big “W.”

Take the Opportunity and Make SureYou Process, Process, Process

Our agency responded to the state’s requestfor potential applicants to implement Fam-ily Centers. We did not get the grant, but

neither did any other applicant. We did ourhomework and it seemed the state felt thatthe city should get its act together and applyas “one”—in other words, collaborate.

The second opportunity to respond to arequest for proposals to establish FamilyCenters came rather quickly. The Mayor’sCabinet for Children and Families was re-sponding to the call. The lead time needed toestablish a community participatory processwas on a short and tight timeline. There wasno paid staff person to facilitate this process,given that at this particular time FamilyCenters were only a wish, not a reality.Nevertheless, the person who accepted theresponsibility developed a process with theinvolvement of the community and pressedon. She was one of those two women men-tioned earlier.

This work included facilitating a process inthree distinct communities simultaneously.Our community was one of those communi-ties. I got a call to help and assisted withorganizing the two to three community meet-ings where we had credible turnouts. Repre-sentation included school personnel, resi-dents, parents, the local library, communityassociations, and other various stakehold-ers. Those who attended were encouraged todiscuss and suggest issues, programs andservices that would be important to the de-velopment of a Family Center responsive tocommunity identified needs. A final meet-ing was held to review the final draft of thewritten document (incorporating the sug-gestions of the community and the require-ments of the funding source) which wassubmitted to the State of Pennsylvania forfunding consideration. A last official act ofthis process called for various communitystakeholders to sign off in support of theproposed submission. We were successfulin meeting these criteria. Congratulations!Philadelphia was awarded a grant to imple-ment three Family Centers.

Our agency was thrilled and so was I. Fi-nally, the dreaming and the “what if?” thatwe indulged in while implementing the healthoutreach program had become a programreality. What an opportunity, and to add tothat bit of joy our agency was named as oneof the entities that would implement a Fam-ily Center site. We were ready. I thought wewere prepared.



Who Told Y’all You Should Be the One!

There was resistance to our agency beingdesignated as an entity to manage a FamilyCenter. We were one of the first to be estab-lished and the first to be managed by acommunity based nonprofit. I said wethought we were prepared. Little did I knowabout the complexity of resistance we wereto encounter, the controversy which wouldrage and the many layers we would have topeel open. The lessons learned hurt, gener-ated anger, opened up the expectation ofexciting possibilities, and provided invalu-able learning lessons all at the same time.Those lessons included: opening our agencyup to merciless scrutiny; providing a cata-lyst for community groups who historicallyhated each other to band together in opposi-tion of us (“Why should they get the con-tract?”); unearthing the issue of race in newand different ways (“Should a white womanbe at the forefront of this movement?” “Whywas our agency supporting her?”); illumi-nating our agency in the eyes of “union”members as a threat to job security (theunion newsletter said of us: “Who are thesepeople anyway . . . watch them . . . cause theydefinitely are union busters”); and variousand sundry discussions among our electedand appointed officials.

All we wanted was an opportunity to shapeanother response to the ways in which chil-dren and families are served. And to do it ourprimary strategy would be to work alongwith the community and build upon ourstrengths in the process. Why was there allthis fuss over this little bit of money? Whyshould anyone be threatened by this effort?I soon found out that it was not about themoney; it was about creating the context thatcould facilitate lessons to be learned andpossibly applied for systems change. Whatwas the real meaning of this rumble? Obvi-ously, we were on the edge of somethingsignificant. But I could not keep up with theissues that religiously cropped up daily.Despite the rhetoric and the relegation ofFamily Centers to the status of “seen themcome and seen them go, we’ll just wait itout,” the behavior bode something different.Neither I, nor these two women, fully under-stood the potential of the outcomes andlessons to be learned by this work. It wasclear that we needed each other to hold on toin this ride.

Open It Up Now Cause We Can’t Wait . .. What Money?

The call came. They wanted us to open upright away! They were worried that time waspassing and we might lose the impact of theconcept of Family Centers if we didn’t makesomething happen. “Open up” I said, “wedon’t have a contract or any money yet.Open up how and with what? We don’t haveany staff.” For a day I thought that womanwas crazy. How was I going to say this to myexecutive director? This is not magic, whereyou have a wand and make it happen. This isreal life. Nevertheless, the resolve and thecold reality hit our agency. Like it or not asfar as Philadelphia was concerned our agencywas named. We had the contract. They werenot interested in mundane things, issuessuch as no money and no staff; besides, tothose who were fighting against us it did notmatter.

We got moving. Those two women and I gotmoving and planning. Those dedicated com-munity volunteers pitched in. We roundedup toys from our homes. I called in favorswith our local businesses and friends: “Hey,give me some furniture . . . I’ll pay you whenour contract comes through,” “Please do-nate some framed art work, remember whenwe paid you well to adorn the walls of ourhousing development sites?” “Please, pleaseMr. Volunteer Townwatch Coordinator, weknow you work at the rug factory in WillowGrove . . . order the rug for us today . . . wewant it delivered in four days . . . yes we willpay you, just use the clout of your companyand I know you have permission from yourboss . . . what do you mean you want us topay for a $369.00 rug, are you out of yourmind?” “How many people from our otherprograms to work on this . . . aren’t youasking for a lot?” “When did you say wewere going to get the money? It’s a goodthing I like you” . . . pick up trash on thewhole block, paint the room, pay for thecatering, do the invitations, mail them out.

I got a call on October 7th from the executivedirector. It seems we had an emergency. Wewere scheduled to open in four days and thehigh ranking official charged with oversightof this initiative was worried. It seems thosecommunity groups had come together, wrotea letter to the mayor and demanded a meet-

ing. All stops were being pulled out to stopthis train from rolling. The high rankingofficial was worried: could we handle this?we cannot afford a major negative spotlight.The principal was worried: he feared a pro-test line as guest would be coming in, couldwe call the police and make sure they wouldbe there? He had been told to expect theworst.

But the opening went off beautifully. It wasemotional; people were crying, happy andexcited. And the Family Center looked as ifwe had taken our time and spent a lot ofmoney to prepare it for the big debut. I wasrelieved. The mayor was happy. He an-nounced that he wanted eight more openedwithin the next year. We had our youthplaying a major role, and on the front page ofthe Daily News was a picture of one youngman and the mayor leaning over to talk in aconspiratorial pose. He was asking the mayorfor a job. The mayor gave him his personaltelephone number and told him to call any-time.

To make the principal happy, I had con-sented to conduct four special presentationsfor students of the school so they wouldunderstand what Family Centers were sup-posed to do. This was “after” the opening.So while everyone breathed a sigh of reliefwhen it was over and went home, I was stillthere responding to my promise. What wasI thinking when I consented to do this, wasI crazy or what?

When I got back to the office, after it wasover, I was treated to a surprise that made mecry. Sitting on my desk was the most beau-tiful arrangement of long stem red roses Ihad ever seen with a card from my boss. Itread: “Struggles are hard won. You did agreat job. Thank you.” He signed his name.Every time someone walks into my officeand asks me why I have those “dead flow-ers” on my bookcase and when I am going tothrow them away, I say “never.”



managing change_______________________________________________________________________

Three Dimensions of Managing Change in Social Service Reformby: Gerald Smale

Editor’s note: The following is an excerpt from the new edition of Gerald Smale’s book Managing Change Through Innovation. (Toorder, see page 38).

Three dimensions of the complex issuesinvolved in working with other people’sideas [when managing change] will be dis-cussed briefly here:

n Leadership;n Other-centredness; andn Sociability: Collaboration and Main-

taining Effective Relationships

Leadership

Before discussing some of the dimensionsof leadership that relate to change manage-ment we need to beware of the danger ofperpetuating the charismatic individual fal-lacy. It is all too easy to take an individual-istic approach to events [and act as if anindividual identified as a charismatic indi-vidual was the only key person crucial tochange]. It may be good enough for touristguides to say that King Henry VIII builtHampton Court or that Lincoln built theWhite House, but a change manager needsmore specific and accurate information.

This raises the complex issue of “what isleadership?” This is discussed in some depthin John Brown’s companion volume to thisbook, Chance Favours the Prepared Mind(1996). Here we will confine ourselves to afew comments to illustrate more dimensionsof the skills used by change agents andchange managers. John Brown’s definitionof leadership is as follows: “Leadership isabout creating the circumstances in whichhigh performance teams can become com-mitted to changing and constantly improv-ing their service delivery” (Brown, 1996).

He is writing from his position as a manager,a team leader, in a social services depart-ment in the UK, an organisation, like most,with a hierarchy. Some people are then putin management positions, which assumessome form of authority or leadership overothers. From this position Brown addressesthe questions about what these people should

do. However, he also discusses the literaturethat questions simplistic notions of all “lead-ership” being invested in only those peoplewith organisational authority. Thus he says:“What we refer to as ‘leadership’ is theinteraction and shared communication aboutdirection, change, and service delivery im-provements between those who have thepositional power and authority to respond tochange proposals and those who deliver theservice” (Brown, 1996).

He follows Adair (1985) and others, seeing“leadership being about influence, consulta-tion, persuasion, support and guidance wherethe key task is to get results from a highlymotivated team” (Brown, 1996).

Brown illustrates the benefits of adoptingchange manager skills within an ordinarysupervisory position. Common issues torespond to will be:

n Seeing conflict as constructive and acatalyst for change, adopting a pluralis-tic metaphor of organisations and teams[by recognising the multiple power basesand vested interests within an organisationor team, acknowledging the vested inter-ests, and seeking collaboration and reso-lution as a healthy response to conflict],and always promoting convergence andcollaboration rather than winning andlosing.

n Always promoting self-questioning inteams and individuals:

t Why are we doing this?t Why does it have to be done this way?t Does it work?t Is there a better way of doing this?t Should we be doing this at all?

n Having integrity and trusting those thatwork for you, encouraging the workers tobe critical of both their supervisors, andthe current team status quo.

n Recognising downward dependence. Asin “Lincoln built the White House” or“Churchill won the war” examples,change managers and team leaders needto recognise that they don’t change any-thing and that changes can not be forced.Commitment has to be given to newpractice, and downward dependencerecognises that the team leader, co-ordinator, manager is relatively power-less in the absence of worker support.

n Seeing the leadership role as a people-developer. It is important to recognisethat, although people and team develop-ment must be highest on the priority listbecause the long term gains far outweighthe short term pains, workload manage-ment and time issues, it is fundamental toadult-learning principles that people learnby themselves; it is not something that isdone to them.

n Seeing commitment as a precious giftthat is rarely given away lightly. Com-mitment is given up by individuals whenthe change task is on that which they areconvinced about. When conventionalwisdom talks of leaders “getting themcommitted” there is a misunderstandingof the relationships involved, which at-tempts to place responsibility for gainingteam enthusiasm and individual commit-ment onto the person occupying the lead-ership role. This is a fallacy. Often thebest thing a leader can do is get out ofpeople’s way and keep his or her mouthclosed and ears open. Commitment isgiven as a gift, not stolen by Machiavel-lian or charismatic people in power(Brown, 1996).

In this book our frame of reference is widerin as much as we are referring to any mem-ber of staff, whether professional practitio-ner, manager or care worker who sets out tobe an innovator, or product “champions” ofa particular change in practice. [Product


“champions” are crucial early adopters ofchange, who not only adopt new methods,but take up the cause of spreading the mes-sage to others (Howell and Higgens, 1990).]This will include those who are in a formalposition where they can, and arguably shouldbring about change. We are also addressingteams of innovatory workers who have de-cided that they want to work in a differentway. The material presented here is alsorelevant to, and has been used to good effectby senior managers and policy makers want-ing to mainstream innovations in their de-partments, just as it is relevant to policymakers wanting to introduce changes inpractice to the system they make policy for.

The effective change agent, or change man-ager, whatever his or her formal position inthe organisation, will be working up, downand across the organisation, and with peopleboth inside and outside it. Over the years wehave come to distrust the “bottom up-topdown” distinction concerning the locationof the initiative for change. Those at the topof an organisation need to work with bottomup innovations just as those at the bottomneed to use the initiatives and resources ofthose at the top. Both will need to work with,and mobilise the resources of people outsideof their organisation where they have noformal authority, or “position” at all . . . [It isimportant to] look for actual gatekeepers ofthe resources that you need for the innova-tion that you are working on. I stress that allindividuals are the gatekeepers of theirown resources of time and effort, ratherthan assume that gatekeepers are only thosewith formal organisational authority. Let usthen look at some of the aspects of leader-ship that are relevant to change agents with-out assuming that they are attached to aparticular organisational role.

Leadership, Vision and Change

Most of the successful innovators that wehave worked with had a clear vision of whatkind of service they wanted to deliver.

There is considerable discussion of “leader-ship” in relation to innovation, and withinthis, there is a frequent emphasis on “vision-ary” and “transformational” leadership. (See,for example, Manz and others, 1989;Beckhard and Pritchard, 1992.) These ideas

clearly imply that those exercising such lead-ership have the imaginative ability to de-velop their own vision of how things mightbe or should be. A “change-master” skillidentified by Kanter is “the ability to articu-late and communicate visions . . . Peopleleading other people in untried directionsare the true shapers of change . . . this secondchange-master skill can be called ‘leader-ship’ . . . this kind of leadership involvescommunication plus conviction, bothenergised by commitment” (Kanter, 1989).

Several different qualities and skills are ratherunhelpfully lumped together here, and wewill return to some of them below, but nev-ertheless, the capacity to imagine, to envi-sion, is seen as underlying many otherbehaviours.

managing change_______________________________________________________________________

"The effective change agent, orchange manager, whatever hisor her formal position in theorganisation, will be workingup, down and across theorganisation, and with peopleboth inside and outside it."

In a similar vein, Beckhard and Pritchardwrite: “The leaders of the organisation musthave a clear vision of the desired end state ofthe entire system, including such dimen-sions as its business, its organisation, and itsways of working” (Beckhard and Pritchard,1992).

This approach might now be seen as theconventional management wisdom withmost management writers emphasising thecentral importance of strategic vision en-capsulated in the organisation’s missionstatement.

Kanter, like many writers in this field, framesthis quality of vision and leadership as es-sentially individualised—this is self-contra-dictory since leadership is by any definitionan interactive or interpersonal event, not anindividual one: for there to be leaders theremust be those that are led. Having the visionmay be the essentially individual dimension

of this “change-master” competency, butinteracting with others in a way that is per-ceived as them being led—the implementa-tion of the vision—is essentially the inter-personal dimension or leadership. We mightremember that the most effective form ofleadership has been said to be where theleader tells people to do what they wouldhave done anyway!

Egan presents an elaborate model of thechange process and the skills of the changeagent within which he identifies three differ-ent kinds of leadership tasks:

t professional technical leadership,t managerial leadership, andt transformational leadership.

Of the latter he writes: “Such leaders usuallyhave a larger vision of things than the othermembers of the organisation, institution, orcommunity . . .” (Egan, 1985).

An analysis of Bob Geldof’s success withLive Aid offers a particularly interestingstudy of visionary leadership and the impor-tance of imaginative abilities. It is particu-larly relevant to us here to recognise that, tobegin with at least, he lacked, or perhaps weshould say “was free of,” a formalorganisation. This enables us to see some ofthe change agent issues without assumingthat they are attached to a role within aparticular organisation. In his study BobGeldof and Live Aid: the affective side ofglobal social innovation (1991), Westleywrites: “In terms of personal background,the early life experiences of visionaries pro-vide them with, at the very least, a core ofintense preoccupation with a vocabulary ofimages which can be used, like templates, toorganise and give meaning to adult forms ofsuch preoccupation. This is true of all people,but visionaries with their particular sym-bolic capabilities are particularly adroit atthe use of this kind of symbolic metaphor”(Westley, 1991).

A methodologically sophisticated empiricalanalysis of the personal characteristics of“champions” of specific technological in-novations across a range of companies con-cludes among other things that “the findingssuggest that fundamental components of achampion’s capacity to introduce innova-


managing change_______________________________________________________________________

tions successfully are the articulation of acompelling vision of the innovation’s po-tential for the organisation . . .” (Howell andHiggins,1990).

To have a vision for the organisation, orclear idea of how practice could be donemay well be a necessary requirement forthose leading change but in our experience itis not enough. Many of the innovatory prac-titioners and managers we have worked withalso took their values and vision literally andacted upon them. They may have been en-shrined in mission statements to be framedand put on the wall of executive offices andmade into posters for the corridors; theywere a working set of values applied toeveryday problem solving. Indeed the com-mitment to solve key problems seemed para-mount. However, we should rememberWatzlawick’s warning that there is no ideamore lethal than a belief that the final solu-tion has been found. In our experience it isperhaps more important that people are com-mitted to solving certain problems and ap-plying benign values in the process. Thisleads us to consider other attributes of theeffective change agent.

Other-centredness

How often do we hear cynical judgements ofmanagers who are said to only be makingchanges to benefit their careers? How oftenthis is a true perception of cynical behaviouris not important for our purpose here. Whatis significant is that true or false such per-ceived motivation is commonly seen as agood enough reason for not collaboratingwith the proposed changes irrespective oftheir intrinsic merits.

The evidence from a range of literature isthat the change agent clearly needs to com-municate that his or her prime concern orinterest is with the needs, interests and con-cerns of the people being worked with, asagainst the interests of the change agent orthe change agency. This can be summarisedas the capacity of the change agent to be“other-centred” in his or her professionalrelationships. This is potentially complex,particularly in the situations social work andsocial services staff commonly find them-selves in of mediating between conflictingparties. Being “other-centred” here entails

being able to tune into several conflictingindividual perspectives, and the relation-ships between them, without being seen tobe taking sides in unhelpful ways.

In his discussion of the change agent, EverettRogers writes that “local change agentsempathise with their clients, and give prior-ity to client’s problems. In fact change agentsare often personally liked by their client’s tothe extent that they seek to circumvent bu-reaucratic rules . . . Change agent success ispositively related to a client orientation,rather than to a change agency orientation”(Rogers, 1983).

Rogers’ work on diffusion of innovation isexemplified in the situation of the profes-sional change agent seeking to diffuse aparticular technological innovation, for ex-ample birth control in Asia, to a clearlyidentified “client” population or target sys-tem. This is sometimes a different situationto that of a middle manager or practitionerseeking to get a team of staff to take on a newway of working. The latter may have moreorganisational constraints to contend withand Rogers (1983) acknowledges that earlyeditions of his work have been criticised forlacking an analysis of organisationalbehaviour. The opposite is often true of mostmanagement writers who look almost ex-clusively at internal organisation factors.For example Kanter (1985), Peters andWaterman (1982), or Senge (1990) are pri-marily concerned with management strat-egy and internal organisational dynamics.This means they tend to fail to recognise thatmany innovations spread throughorganisational boundaries and that it is theoverall social network of staff that is impor-tant, not just their intra-organisational lives.Nonetheless the need for the manager/changeagent to be essentially “other-centred” re-mains crucial in all of these situations.

Allibrand and Benson, in their study of train-ing for rural change agents in the third world,underline the need for change agents towork with the immediate problems of theindigenous population. [They argue: “Ef-forts to shortcut the development process byfinding ‘peasant-proof’ modernisation meth-ods have been largely unsuccessful.” Theygo on to say: “Frankly, we feel it is high timefor change agents to listen more and talk less

. . . Rural change agents should be concernedwith the immediate specific needs of theirclients” (Italics original-Allibrand andBenson, 1980).] Their argument against“peasant-proof” innovations underlines theneed for change agents to avoid what isessentially self-centred thinking. Just as it isuseless for us to adopt other people’s solu-tions to their problems unless they are iden-tical to ours and our circumstances, so it isuseless for others to have our solutions im-posed upon them.

A major practical implication of an “other-centred” orientation is that the capacity ofthe change agent to be able to listen to thosewith whom he or she is working can not beassumed to be present. It is often assumed tobe happening when it isn’t, and assumed tobe a relatively simple task which everyonewill naturally do when, actually, effectivelistening may be more the exception than therule. Everett Rogers, for example, remindsus that “Change agent empathy with clientsis especially difficult when the clients arevery different from the change agents”(Rogers, 1995).

We have found the opposite also true. Ininteractional skills training for social work-ers and supervision skills development withmanagers we found that the interviewer fa-miliar with the interviewee’s problems some-times made serious mistakes. This hap-pened when the manager or worker jumpedahead of the other person assuming that theyalready knew what they were going to saybased on their own experience of the prob-lem or situation. They thus failed to hear andso empathise with the other person’s ownexperiences.

"The change agent clearlyneeds to communicate that hisor her prime concern or inter-est is with the needs, interestsand concerns of the people be-ing worked with."


managing change_______________________________________________________________________

The fundamental, core issue of the need torediscover problems and recognise their id-iosyncratic significance, and the need forconstant reinvention, is illustrated in Dr.David Riley’s work. By listening to localisedproblems and frustration about gettingsomething done, or there being somethingwrong in the situation, the change agent orchange manager gathers information andperceptions in collaboration with others, aprocess of gaining consensus and commit-ment to doing it some other way.

Riley (1997) describes an excellent practi-cal example of using listening and local datagathering approaches “to the process of thediffusion of innovation” when applied to apublic health and community developmentinitiative in Wisconsin. Having successfullyintroduced a pilot programme for “latch-key” after-school child-care in one area ofWisconsin, he began a “simple-linear” ap-proach to the statewide dissemination of thesuccessful pilot. He encountered a range ofindifference and resistant responses, in whicheach locality or community simply said tohim that they did not accept that the “prob-lems” from another area of Wisconsin hadany relevance for their area of Wisconsin—a classic “not invented here” response.

It was only when he altered his strategy froma simple-linear approach to one of locally-based convergence, collaboration and rein-vention in every single community or town,that they began to see that there was a prob-lem in their area and the commitment tosolution-generation began. Riley had toliterally reinvent the data collection to high-light the problem in each single town beforethere was any acceptance for the solutionsthat were available. Even then, he himselfhad to accept that there was a need for eachtown to modify and tailor the existing solu-tion to their own local needs. He had to helpthem to reinvent the problem before he couldintroduce solutions. The phenomenal suc-cess that was achieved having moved awayfrom a simple-linear approach bears testi-mony to his comments that:

I had not heard of anything like thisbefore, and nothing in my graduatetraining had prepared me for this fac-tory-like way of replicating the sameresearch again and again. My depart-

mental peers were also a bit mystifiedat first. Was this real research? I wasfinding basically the same results ineach community, so why didn’t I justpublish it and go on with the nexttopic? The answer to this questionimplied a redefinition of theresearcher’s role and audience. Ofcourse I knew what we would find ineach new community, but the com-munity did not, and they each had tofind out for themselves. They did notbelieve that research conducted else-where was relevant to their town. Insome cases, local leaders (such asschool administrators) told us theywere politically unable to advocatefor after-school programmes until wecreated a public demand, which theycould then answer. In such cases, weacted as a catalyst and probably has-tened a process that would have takensome additional years otherwise.

One might say that instead of diffus-ing knowledge, I was diffusing theknowledge-generation process, teach-ing community members to be theirown researchers. (Riley, 1997)

Here we see the combination of listeningand other-centredness, in this instance arecognition that his knowledge is irrelevant.It is the knowledge of others that is impor-tant.

Others, writing about the world of industryand commerce, underline the crucial impor-tance of these dimensions of change man-agement. For example, Moss Kanter pro-vides another perspective on the importanceof listening, which itself can only come froma basically “other-centred” disposition inthe change agent, when she writes: “Thusactive listening to the information circulat-ing in the neighbourhood is really the firststep in the generation of an innovative ac-complishment, and information is the firstpower tool” (Kanter, 1985).

Another level of “other-centredness,” andthe ability to hear the communications ofothers is evident in the study of Bob Geldofand Live Aid. Bob Geldof writes of switch-ing on the television as a diversion from hisown worries about a recently produced

record: “I saw something that placed myworries in a ghastly new perspective. Thenews report was of famine in Ethiopia. Fromthe first seconds it was clear that this was ahorror on a monumental scale . . . I feltdisgusted, enraged . . . To expiate yourselftruly of any complicity in this evil meant youhad to give something of yourself . . .”(Westley, 1991).

Geldof’s description clearly conveys a ca-pacity for “other-centredness” both in thesense of being able to hear the communica-tions of the television programmes, and alsoin the sense of moving beyond his ownpreoccupation and concerns in order to actin an “other-centred” fashion. Clearly any-one seeking to promote change at either theglobal scale which Geldof sought, or themicro level scales of the averageorganisational middle manager or practitio-ner, will require some minimal capacity forthe same attitudes and behaviours.

A major study on the training of changeagents conducted in the 1970’s involvedbringing together a conference of academicsand expert practitioners and getting them toidentify levels of agreement on generalpropositions about the nature of changeagency. Two propositions which receivedthe highest proportion of agreement as es-sential to the effective change agent were:“The user’s need is the paramount consider-ation in any planned change activity”; and“User initiated change is likely to be stron-ger and more long lasting than change initi-ated by outsiders” (Havelock and Havelock,1973).

These statements are expressions of the im-portance of an essentially “other-centred”orientation required of the change agent.The fact that this might appear more com-plex for many managers and practitionerswho have to attend to several “users” withpossibly conflicting perceptions of their ownand each other’s “needs,” simply underlineshow crucial it is for the change manager orchange agent to be able to maintain such anorientation.

Sociability: Collaboration and Maintain-ing Effective Relationships

There is a common stereotype of the innova-


managing change_______________________________________________________________________

tor as an oddball, somebody who is thinkingin his or her own world and out of step withothers, the eccentric “nutty professor” or“mad inventor.” There is perhaps some truthin these ideas concerning inventors and veryearly adopters. However, in our experienceeffective change managers combine theirwillingness to step out of line and take on theconventional wisdom with an ability to workcollaboratively even if this is restricted to ateam of like-minded pioneers. More fre-quently though the effective change agentswe have worked with have good social skillsand are motivated to form partnerships andcoalitions with a wide range of disparatepeople.

Change agents work with and through otherpeople. They need to be capable of sufficientindependence to be able to function in a thirdparty position relative to key relationships,organisations and social networks of people.However, it is also crucial that the changeagent is able to develop a range of ways ofjoining with, and working alongside otherpeople. They need to be able to do this in awide range of configurations including indi-viduals, both in the same organisation andoutside, and including both subordinatesand superiors; groups of different sizes,whole communities, organisations, networksand so forth. The negotiation of convergentunderstandings is essentially a social pro-cess, and thus requires in the transactor ageneral capacity to engage effectively withother people.

Evidence from a diverse range of literaturesupports this view. For example, Kanteridentifies “coalition building” as the first ofseveral interpersonal and organisationalskills. She writes: “Though the literature onorganisational politics has emphasised one-on-one relationship building, my researchmoves the emphasis to the coalition. Whatmakes people effective in organisations isthe ability to create a whole set of backersand supporters, specifically for projects ofinnovative activities, that helps lend thepower necessary to vitalise these activities”(Kanter, 1991).

Collaboration is seen in this context of de-veloping innovations and managing changein large companies and commercialorganisations as an element in a change

strategy. Within this strategy there will be arange of tactics in relation to the develop-ment of particular coalitions. For example,Kanter describes “an attractive youngwoman” who proved to be a highly effective“change master”: “She brings others intoprojects; she works with peers and peoplebelow to make them feel included. She cre-ates multiple relationships . . .” (Kanter,1985).

Weissman’s study of entrepreneurship insocial work concludes that “While all entre-preneurs need interpersonal skills, the socialentrepreneur is probably more dependent onsuch skills than his counterpart in business.Although both business and social entrepre-neurs must be adept in dealing with people,the social entrepreneur needs to be espe-cially well-versed in organisational and gov-ernmental politics and processes”(Weissman, 1990).

Being “well-versed” here does not just re-late to an intellectual understanding of suchprocesses—it refers to all that is involved inthe social activities of “‘making deals’. Inthe political arena, this activity may involve. . . obtaining sponsorship of key supporters. . . getting officers to authorise projects andallocate staff . . . reach agreements withother program managers, and so forth”(Weissman, 1990).

Such activities require the change agent tobe able to work in lots of different ways withmany different kinds of people, i.e. to befundamentally sociable.

Kanter identifies a second “interpersonalskill” which she characterises as team build-ing: “Once a group of supporters has beengenerated, it is time to get down to the actualproject work. Now the next interpersonal-organisational skill comes into play—theability to build a working team to carry outthe idea” (Kanter, 1991).

In this she seems to be using the samedefinition of “team” as referred to through-out this book: a team is a group of peoplerelated to each other to complete a task.Essentially then we are talking here aboutover-lapping collections of people withinand across organisational boundaries andnot just the “teams” that constitute part of

many organisations’ structures. John Brown(1996) has discussed issues to do withorganisational team development and themanagement of change and development ofinnovations in some detail in the companionvolume to this book.

In his study of Live Aid, Weissman (1990)identifies that a crucial feature of BobGeldof’s success in mobilising the Live Aidappeal was his familiarity with the interna-tional network of people involved in the popmusic industry, and his ability to use theserelationships to generate a snowball of com-mitment.

Everett Rogers concludes from his exten-sive review of the literature on innovationsthat “Change agent success is positivelyrelated to the extent that he or she worksthrough opinion leaders . . . The time andenergy of the change agent are scarce re-sources. By fostering communication ac-tivities upon opinion leaders in a social sys-tem, the change agent can hasten the rate ofdiffusion . . . In fact, after the opinion leadersin a social system have adopted an innova-tion, it may be impossible to stop its furtherspread” (Rogers, 1995).

As well as the “economic” argument forworking through opinion leaders, the needfor this is also a function of the need for thechange agent to be able to remain in a thirdparty position. The opinion leader is, so tospeak, the person in the client network whois just over the fence from the change agent,but well connected in the client territory, andthrough such links the change agent canboth be sufficiently involved and sufficientlyindependent.

Roberts and King, in their study of policyentrepreneurs, discuss the practical tasks oflinking up innovators, developing and main-taining support networks, and bringing to-gether practitioners, researchers, as part ofthe change agent’s task. They write: “Thepolicy entrepreneurs tended to organisethemselves into a group of individuals . . .(they) usually met once a week and . . .regularly kept in contact by telephone . . .‘Informed others’ would be invited to sit in. . . Forums to discuss their ideas ranged frominformal ones such as public speaking en-gagements, university courses, leadership


managing change_______________________________________________________________________

development programmes . . . Our respon-dents also cited the policy entrepreneurstelephone calls, personal contacts . . . andspecial meetings that brought together na-tional education ‘experts’ with state andlocal political and educational leaders” (Vande Ven and others, 1989).

These policy entrepreneurs/change agentsengage in highly complex and enriched so-cial relationships as part of their ways ofinfluencing the situation and providing sup-port and challenge to themselves and othersin the change process. Some of the rules ofthumb developed by one of the subjects oftheir research included: “Change nevercomes through consensus. Get the key lead-ership to back your idea and ‘the pack willrush to follow’ . . . Get the elite involved . .. Destabilise the opposition by co-optingone of the . . . establishment groups” (Van deVen and others, 1989).

Our own experience of working with inno-vators has certainly endorsed the crucialsignificance of diffusion (we called thempractice exchange networks) in supportingand sustaining innovators and innovatoryteams. These people were typically rela-tively isolated in their own organisationsand received much information as well asessential support from these networks. Itfollows from this that change agents andinnovatory managers need to be goodnetworkers. Indeed Rogers (1995) concludesthat the cosmopolitan nature of innovatorsand early adopters is a key personal charac-teristic.

In their study of leadership and innovationManz and others (1989) examine the pro-cess by which a new chief executive, whowas installed against the wishes of a newlyacquired company, sought to “join” with theorganisation. They write: “This leader spenta great deal of time and energy initially bothtrying to assimilate the style of the acquiredorganisation and coming to understand therhetorical vision of the community. He didthis through intensive and constant personalcommunicative involvement with the entirestaff . . .” (Manz and others, 1989).

An essential element of the change processhe was managing consisted of intensive,face-to-face contact with staff, essential for

actually understanding the perspectives ofthose with whom he had to work in order tobring about the necessary changes.

These are all examples of the change agentdeliberately planning to work through andwith other people, and through theirrelationships with those who the changeagent seeks to influence, i.e. the changeagent requires the cognitive, attitudinal,and behavioural abilities to work socially,in many different ways.

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Riley, D.A. (1997) Using local research tochange 100 communities for children andfamilies. American Psychologist, Vol. 52No. 4 pp. 424-433.

Rogers, E.M. (1983) The Diffusion ofInnovations. 3rd Edition. New York: TheFree Press.

Rogers, E.M. (1995) The Diffusion ofInnovations. 4th Edition. New York: TheFree Press.

Senge, P.M. (1990) The Fifth Discipline:The Art and Practice of the LearningOrganization. New York: Doubleday.

Van De Ven, A.H., Angle, H.L. and Poole,M.S. (Eds.) (1989) Research on theManagement of Innovation: The MinnesotaStudies. Grand Rapids: Ballinger/Harper andRow for the University of Michigan.

Weissman, H.H., Ed. (1990) Serious Play:Creativity and Innovation in Social Work.Silver Spring, MD: NASW.

Westley, F. (1991) Bob Geldof and Live Aid:the affective side of global social innovation.Human Relations, Vol. 44 No. 10 pp. 1011-1036.


Outcomes Consultation: Lessons from the Field (Part II)The Automated Assessment of Family Progress

by: Brad Richardson and Miriam J. Landsman

In Part I of this series, five principles that guide the process of establishingoutcome-based systems were presented. Those principles are listed in thebuilding blocks to the right. The application of those principles was embel-lished by a case example of outcomes consultation (a.k.a. technical assistanceon outcome measures). In this issue we will present an approach todeveloping a statewide common outcome measures system. This approachhas also resulted in the development of a simple and inexpensive computer-ized data collection system by which to examine data for families seekingassistance from community action agencies. These data provide strengths-based monitoring and assessment for the families, their workers, and othersinterested in positive growth for vulnerable families. In aggregate, the dataalso provide measures of change and point in time assessment at several levelsof analysis. These data may be analyzed by geographic area (counties, agencyservice areas, statewide), programmatically by services received, over time(time series), or for establishing validity and reliability.

Developing Statewide Outcome Measures

The Automated Assessment of Family Progress developed from work attrib-utable to staff at MICA (Mid-Iowa Community Action) and the NationalCenter for Services Integration (Bruner, 1992). Using the MICA categoriesand definitions as a starting point, and after many, many hours of meetings,drafts, reviews, and negotiations, the AAFP represents the culmination of arefinement process for the original constructs. The major difference betweenthe AAFP matrix and the MICA outcomes is that the AAFP presentsmeasurable strengths-based indicators (scales) under each outcome area.Paying particular attention to Principle #1: involvement of stakeholders, andPrinciple #2: achieving relevance, cultural appropriateness, and consensus,the following ten family-strength categories determine the “matrix”:

l Employmentl Educationl Community Involvementl Self-Sufficiencyl Household Managementl Food/Nutritionl Healthl Housingl Emergency/Crisisl Household Linkages

These outcomes, along with their associated measures and the process(described below and illustrated in Figure 2) have become known as theAAFP. The measures in each column of the matrix under the general conceptrepresent the scales used to measure the state of the family at points in time.Family progress is the analysis of change on those measures contained in theAAFP database.

t Principle #1: No matter what system is taking the lead rolein developing an outcome based system (state, local, etc.),the involvement of stakeholders in developing outcomesand measures of those outcomes is critical to developing avalid outcome system. An outcome system developed at thestate level must be accountable not only to federal fundingsources but also to the local level, actively involving locali-ties in the process. Therefore, whatever system is leadingthe outcome based project, stakeholders must be preparedfor the length of time and extent of commitment of effortthat the project will require.

t Principle #2: The desire for uniform outcomes must beconsidered in light of the nature of the service system, thediversity of the population, and a variety of communityfactors. While uniform outcomes are the easiest to measureand report, several important questions must be raised: 1)are the same outcomes relevant to all locales within a regionor to all regions within a state?; 2) are outcome measuresdeveloped in ways that are appropriate to culturally diversepopulations?; and 3) can stakeholders reach consensus onhow desired outcomes can best be measured?

t Principle #3: As a rule, the greater the heterogeneity, themore complex the task of developing an outcome basedsystem. A statewide evaluation of a relatively homoge-neous program with clear outcomes will be less complicatedto implement than an evaluation of a community basedcollaborative of assorted programs, each serving differenttarget populations, providing different types of services,and having varied (perhaps even intangible) outcomes.

t Principle #4: Key to developing an outcome based servicesystem is maintaining a focus not exclusively on the mea-surable outcomes, but on the linkages between outcomesand services. In the current fervor for developing measur-able outcomes, too often the relationship between outcomesand programs and services is neglected. Outcomes areintended to represent changes which occur as a result ofinterventions. Tracking indicators in the absence of aservice context, therefore, provides little useful informationabout the role of programs in attaining those changes.

t Principle #5: The logical sequence of developing anoutcome based system begins with a thorough understand-ing of the needs which prompt a service or system ofservices and the goals developed to address those needs. Ifa community is experiencing a high rate of adolescentpregnancy, an important goal will be to reduce the rate ofadolescent pregnancy. Outcomes, then, are the measurableresults by which attainment of the goal will be evaluated.Outcomes do not develop out of thin air, or apart from acontext of needs.

research exchange--outcomes consultation_________________________________________________


research exchange--outcomes consultation_________________________________________________


Figure 2

Research Exchange--outcomes consultation_________________________________________________


Achieving the first two principles— involve-ment of stakeholders and consensus—re-quired working with the State of Iowa De-partment of Human Rights, Division of Com-munity Action Agencies (DCAA) and suc-cessfully partnering with the Iowa Commu-nity Services network. This network includedthe Iowa Community Action Association(ICAA), the Iowa Commission on Commu-nity Action Agencies (CCAA), and the Uni-versity of Iowa School of Social Work’sNational Resource Center for Family Cen-tered Practice. The partnership has resultedin the design and implementation of whathas been called, at the Federal level, a Re-sults Oriented Management and Account-ability (ROMA) system addressing the fed-eral accountability standards of GPRA (Gov-ernment Performance and Review Act).

Principle #3 states that the greater the het-erogeneity, the more complex the task ofdeveloping an outcome based system. De-velopment of the AAFP began in 1996 whena proposal from the State of Iowa, Divisionof Community Action Agencies was writtento the Office of Community Services at theDepartment of Health and Human Services.With a modest award for start-up, the workon the grant began to address issues of theirmeasurement, validity and reliability. De-fining the set of outcome indicators beganwith a core group of Community Action andState agency staff. Following the manymeetings and planning sessions to developthe indicators, it was determined that a com-puterized system would be used to collectthe data, store the data, and then to simulta-neously export the data from the collectionsites to a central location for aggregation,analysis and reporting. Since sites used morethan one kind of computer system, it wasalso agreed that spreadsheets would be usedas a common vehicle to transfer informa-tion.

The AAFP was written as an additionalscreen which was included in the computersystems used for gathering intake informa-tion at sites across the state. Following pilottesting, the additional AAFP measures wererecorded for selected participants beginningin 1998.

Instead of measuring each family, a sam-pling procedure was used to reduce the

amount of time necessary to collect andenter data and thus reduce the cost of the datacollection. The sampling procedure ensuredthat every household had the same chance ofbeing selected regardless of when the familyappeared (those that appeared for serviceslate in the year had to have the same chanceof selection as those that appeared early inthe year), or how often they appeared(whether once a year or several times eachmonth). Our goal was to achieve a randomsample of a size which would obtain a 95%confidence level. Agencies were also al-lowed to use the AAFP process to assessparticipants in designated service programs.As a result, households could be included inboth the random and agency selected groups,either one of those groups, or neither of thegroups.

The AAFP process is ongoing according tothe steps in the flowchart illustration (Figure2). Once the household record is marked ashaving been through the selection process,each time the family appears they are askedthe AAFP questions. Non-selected familiesare so marked and do not become part of therandom sample; however, they may be se-lected by the agency at any time for specialanalyses (e.g., all participants in a new pro-gram might be selected). These data are thenexported for aggregation and analysis at theNational Resource Center for Family Cen-tered Practice.

Next Steps: Linking Outcomes to Service

Principle #4 states that the key to developingan outcome based service system is main-taining a focus not exclusively on the mea-surable outcomes, but on the linkages be-tween outcomes and services. Connected tothe AAFP are the service provision data thatthe state maintains and household demo-graphic data (e.g., date of first service, num-ber of household members). As the AAFPwork proceeds we will attach specific ser-vice data to the outcome measures. This willprovide rich information on inputs associ-ated with specific outcomes, and will ulti-mately provide information critical for theanalysis of cost. An empirical system ofservices and outcomes is being establishedwhich can enhance our ability to assess andimprove service effectiveness for families.

Principle #5 states that understanding com-munity needs and the system of servicesdesigned to meet those needs is a major goalof outcome evaluation (Principle #5). TheAAFP process is also intended to build localcapacity to further understand the connec-tions between community needs and ser-vices. During the summer of 1999, local andregional training will be conducted with allagencies in the state implementing the AAFP.The training will consist of procedures fordata manipulation and analysis in some ofthe following areas:

l Assessing validity of outcomes andscales

l Assessing reliabilityl Examining linkages between service

delivery and outcomesl Program participation levels and out-

comesl Cost effectiveness of programsl Procedures for analyzing change

over timel Presenting information to funding

sources

For more information contact us at:

[email protected]; Phone(319) 335-4934

[email protected]; Phone (319)335-4924__________________

References

Campell, D. T. & Fiske, D. W. (1959).Convergent and discriminant validation bythe multitrait-multimethod matrix. Psycho-logical Bulletin, 56, pp. 81-105.

Bruner, et al. (1994). A framework formeasuring the potential of comprehensiveservice strategies. National Center for Ser-vice Integration Resource Brief 7, p. 31.

Research Exchange--outcomes consultation_________________________________________________


Resource Review

by: Ashly Bennett

Bruner, Charles. From Community-Based to Community-Staffed: TheExperiences of Three Allegheny CountyFamily Centers in Community Hiring.Pittsburgh: Starting Points, Office ofChild Development, University ofPittsburgh.

This report recounts the recent developmentof three family centers in AlleghenyCounty, Pennsylvania that are staffedalmost completely by members of thecommunity being served. The report beginswith a brief discussion of the potentialbenefits of community hiring, as well as thecommon obstacles to it. The chronology ofeach site’s development is described, alongwith the challenges that the directors had toovercome in order to effectively implementa community hiring process. Theperspectives of the staff members on theirwork experiences, and those of familieswho worked with community staff are alsoincluded. A number of lessons learned bythose involved are outlined at the end of thereport, touching on a variety of issuesincluding leadership, communitygovernance, recruitment, and the economicbenefits of community hiring. Theselessons, as well as the concise report as awhole, should be relevant to anyoneinvolved or interested in community hiring.

Dorman, Rebekah L., Douglas J. Moore,and Caroline A. Schaerfl. (1999).Planning, Funding, and Implementing aChild Abuse Prevention Project .Washington, DC: CWLA Press. ISBN 0-87868-562-6.

Wanting to go beyond the abstractdiscussion of child abuse prevention foundin most literature on the topic, the authors ofthis manual provide detailed, practicalinstructions on developing a child abuseprevention project. Based on over 100prevention projects in Ohio, the manualtakes the reader through all the steps ofdesigning and implementing a program,and offers advice on securing funding,cultivating cultural competency among

staff, establishing an effective organizationalframework, and a number of otherimportant issues. Case examples from Ohioprojects are detailed throughout to illustratethe procedures described. The authors alsopoint readers to other useful resources andinformation; reference lists at the end ofeach chapter offer further material on thetopics covered, and the appendices includelists of federal resources for child abuse andneglect prevention activities, nationalorganizations and information sources thatfocus on abuse prevention and/or familysupport, and publications on related issues.

Goldman, Sybil K., Marisa DelacruzIrvine, and Cliff Davis. (1999). Report ofthe Child, Adolescent, and Family Panelfor the Mental Health Managed Care andWorkforce Training Project. Washington,DC: Georgetown University NationalTechnical Assistance Center forChildren’s Mental Health.

This publication includes two reportsintended to help mental health professionalscreate successful systems of care inmanaged care contexts for children withemotional/behavioral problems and theirfamilies. As part of the Managed CareInitiative, the Child, Adolescent and FamilyPanel was made up of individuals with arange of perspectives and expertise onmental health services for this population.In the first report, the panel assesseswhether the standards, practice guidelines,core competencies, and training curriculacurrently being used by differentconstituencies, particularly in managedcare frameworks, adequately incorporatewidely held, core principles for mosteffectively serving youth and families. Thepanel identifies the limitations and strengthsof existing materials and suggests thedevelopment of consensus on practicestandards and recommended corecompetencies based on best practice andcollective practical wisdom. In the secondreport, the panel offers a list of principlesthat should guide the development of suchstandards and competency requirements.

Standards for both management and clinicalwork are also proposed, accompanied bynotes on each standard concerning importantaspects of its implementation. Some initialrecommendations of competency guidelinesfor staff are also included. A combinedexecutive summary for both reports at thebeginning of the document provides auseful overview of the panel’s findings andsuggestions.

Gray, Bruce, Angela Duran, and AnnSegal. (1997). Revisiting the CriticalElements of Comprehensive CommunityInitiatives: A Study Conducted by Staff ofThe Office of the Assistant Secretary forPlanning and Evaluation, United StatesDepartment of Health and HumanServices. http://aspe.os.dhhs.gov/hsp/cci.htm

This online report based on a study offourteen comprehensive communityinitiatives offers observations and insightson succeeding in such endeavors. Thedevelopment and methodology of the studyare described, including the process ofidentifying initiatives from across thenation that are considered successful byexperts and meet the criteria of: 1) operatingfor at least the past five years; 2) usingmultiple funding sources; 3) providingmultiple services and supports; 4) focusingon improving the status of families andchildren; and 5) being large enough to havesignificant impact on the community. Thereport outlines the principle lessons learnedabout the survival and success ofcommunity-wide initiatives throughinterviews with administrators, staff,residents and organizational partnersinvolved with the selected initiatives. Keytopics relating to success that werediscussed during interviews are alsoexamined, including: mission, vision andphilosophy; leadership and management;responsiveness to community needs;community participation; collaboration;and financing. The authors conclude byconsidering and, in some areas, challengingconventional wisdom about creating

resource review_________________________________________________________________________


comprehensive support systems for familiesand children in light of the findings of thestudy, suggesting ideas and strategies thatwill be useful to anyone involved in thisfield.

Jargowsky, Paul A. (1997). Poverty andPlace: Ghettos, Barrios, and the AmericanCity. New York: Russell Sage Foundation.ISBN 0-87154-405-9.

With this book, Jargowsky offers the firstnationwide study of high-povertyneighborhoods. Defining high-povertyneighborhoods as those with at least 40%poverty rates, he documents and examinestheir alarming rate of growth between 1970and 1990, identifying national trends. Healso closely examines the size and scope ofpoverty in 1990 and offers a description ofthe physical, economic, and socialcharacteristics of high-povertyneighborhoods that poses many challengesto popular stereotypes. After consideringthe growing body of literature onconcentrated urban poverty, Jargowskyoffers his own analysis of neighborhoodpoverty and discusses its implications forpublic policy. The book has a very scholarlybent, putting great emphasis on methodologyand statistics, and provides a comprehensiveinvestigation of impoverishedneighborhoods and a well-supportedargument for rethinking strategies foraddressing them.

Jernberg, Ann M., and Phyllis B. Booth.(1999). Theraplay: Helping Parents andChildren Build Better RelationshipsThrough Attachment-Based Play, 2 nd ed.San Francisco: Jossey-Bass Publishers.ISBN 0-7879-4302-9.

In the late sixties, Jernberg, Booth and otherindividuals involved with the Chicago HeadStart program developed Theraplay, aninnovative approach to child therapy thatfocuses on creating a playful, interactiverelationship between the therapist and childthat is modeled on healthy parent-childinteraction. This helps the child addressattachment issues, increase self-esteem anddevelop age-appropriate behaviors, whilealso teaching parents, who initially observeand then participate in playing with thechild, new techniques they can continue to

use at home. Jernberg first described themethod in the 1979 edition of this book, andin this new edition Booth revises theoriginal to reflect recent changes in childdevelopment theory and the Theraplayapproach itself. A general overview of themethod is provided, as well as a discussionof the theory and research informing it.Detailed instructions on Theraplay treatmentare also given, including how to work withthe child and the parent or other caregiver,and how to organize sessions around achild’s unique needs. Numerous vignettesand transcripts of Theraplay sessions areincorporated to exemplify different aspectsof the technique. Specific problemsTheraplay can be used to address, such asautism and physical disabilities, arediscussed, as well as adapting the method towork with adolescents. The book presentsan approach that is relevant to a wideaudience, including both professionals andparents, since aspects of it can beincorporated into many types of work andeveryday interactions with children; but,therapists planning to add the Theraplaymethod to their practice are encouraged touse the book in conjunction with formaltraining.

Keehley, Patricia, Steven Medlin, SueMacBride, and Laura Longmire. (1997).Benchmarking for Best Practices in thePublic Sector: Achieving PerformanceBreakthroughs in Federal, State, andLocal Agencies. San Francisco: Jossey-Bass Publishers. ISBN 0-7879-0299-3.

This book describes how to improve anypublic organization through benchmarking,a process of comparing the practices ofone’s own organization to the best practicesof others with similar services. The authorsprovide a step-by-step guide to implementingbenchmarking techniques, covering a rangeof topics from preparing for benchmarking,to identifying best practices in otherorganizations and adapting these to one’sown organization. The authors also discusshow to create an effective, diversebenchmarking team, and how to select andinteract with benchmarking partners that

have practices you wish to adopt. While theauthors consider other literature onbenchmarking, the emphasis is on providingdetailed, concrete advice. Numerousexamples of both public and privateorganizations that use benchmarking areoffered to illustrate different aspects of it. Inaddition, flow charts, checklists, worksheetsand other useful tools for benchmarking areprovided. This practical guide should be ofinterest to any individuals in federal, state orlocal agencies who wish to enhance theirpractice.

Krueger, Mark A. (1998). InteractiveYouth Work Practice. Washington, DC:CWLA Press. ISBN 0-87868-707-6.

The first publication in a series of youthwork resources, this book encouragesindividuals who work with youth to developan interactive approach to their practice. Ina series of essays, Krueger discussespersonal experience and examples of youthwork, along with research and literature onrelated issues, to demonstrate that youthdevelop in moments and interactions, andworkers must be aware of a youth’sdevelopmental capacities. Characterizingcompetent youth work as a constantlearning process, he explains how workerscan develop the ability to adapt techniquesto specific contexts and a youth’s individualstrengths, abilities and readiness forgrowth. He also includes a curriculumoutline that can be used to teach interactiveyouth work practice in a classroom or worksetting, and provides practice examples fordiscussion. In addition, an extensivesuggested reading list is offered, along withan overview of authors, books, articles andvideos that have been particularly influentialon Krueger’s approach to youth work.

Orelove, Fred P., and Howard G.Garner, eds. (1998). Teamwork: Parentsand Professionals Speak for Themselves.Washington, DC: CWLA Press. ISBN 0-87868-602-9.

This collection of essays addresses theimportance of teamwork among practitionersinvolved in different areas of education,health care and human services, andprovides ideas and information to helpfacilitate such collaboration. The first few

resource review_________________________________________________________________________


essays discuss how forming structuredteams of professionals from differentdepartments in an organization or evenfrom separate agencies, that also includeparents of children receiving services,results in better support for and increasedsatisfaction of customers. A number ofgeneral issues relating to teamwork areexamined, including the history of teams inhuman services, the challenges andopportunities of collaboration, and thestages of team development. The rest of theessays are contributed by participants inteam efforts from ten traditional helpingdisciplines: medicine, nursing, physicaltherapy, occupational therapy, specialeducation, social work, speech-languagepathology, psychology, rehabilitationcounseling, and gerontology. Each of theauthors gives a brief history of his/herprofession, describes services provided andcurrent philosophies of treatment andservice, and discusses the professional ethicand the training process. Each alsoconsiders the discipline in relation to othersand offers his/her perspective on key issuesrelating to working on a team. The book is avaluable resource for parents, professionalsor others interested in information on thegrowing trend of interdisciplinary teamwork,and on the individual professions that aredescribed.

Pipher, Mary. (1997). The Shelter of EachOther: Rebuilding Our Families. NewYork: Ballantine Books. ISBN 0-345-40603-6.

In this bestseller, Pipher draws on herexperience as a family therapist to examinehow culture affects the mental health offamilies. Throughout the book she combinesrecollections of her own family, accounts ofher work with families, and theorizing onfamilies in general, achieving an engagingbalance between story-telling and drawingbroader questions and conclusions from hernarratives. The style and content invite not

just therapists but anyone interested in thestate of the family to consider prevalentchallenges facing it and possible solutionsto these. Positing that our culture is “at war”with families, Pipher explores how a varietyof contemporary pressures and issues shapeand often hurt families. She considers thedramatic shift in the functions and conditionof the family over the last century,illustrating this through a comparison of hergrandparents’ experiences and those of afamily she saw in therapy. While recountingthe stories of many of her clients, sheacknowledges the limitations of therapyand theory—at one point even listing tenmistakes that therapists make—and offerssuggestions on how to make therapy moresuccessful. She also discusses other waysfamilies can survive in the currentenvironment, which include protectingfamily members from harmful exteriorinfluences while also connecting them withpositive influences and resources.

Webne-Behrman, Harry. (1998). ThePractice of Facilitation: Managing GroupProcess and Solving Problems. Westport,Connecticut: Quorum Books. ISBN 1-56720-067-2.

Webne-Behrman draws on his work withhundreds of businesses, organizations andpublic agencies to offer this guide onfacilitating meetings applicable to almostany context. Defining a facilitator as anyonedesignated by the group to be the caretakerof the meeting process, he outlines thisindividual’s responsibilities and describesthe communication skills he or she shouldhave and model for the rest. He alsoprovides comprehensive instructions fororganizing the necessary phases of afacilitated meeting, as well as strategies andactivities that can be used to help the groupmembers participate in systematic problemsolving and resolve conflicts. The processof building consensus is described, includinga discussion of whether unanimousconsensus or other democratic decision-making options should be used. Teamdevelopment is also discussed, along withthe stages of group development over aperiod of time and the facilitator’s role inthese. The book concludes with an

resource review_________________________________________________________________________

interesting overview of diverse philosophicaltraditions that have contributed to theconcept of a facilitator. Throughout,Webne-Behrman successfully incorporatespersonal experience, examples from a widevariety of organizations, and relevantliterature and research to offer bothpractical advice on facilitation and aprovocative exploration of larger issuesrelating to effective group process.

We welcome the submission of ar-ticles for future issues of The Pre-vention Report. If you are inter-ested please contact and/or sendyour manuscript to:

John ZalenskiInformation Director

National Resource Center forFamily Centered PracticeThe University of IowaSchool of Social Work

100 Oakdale Campus #W206 OHIowa City, IA 52242-5000

(319) 335-4965FAX (319) 335-4964

[email protected]


FAMILY DEVELOPMENTFamily development is a model of familybased intervention designed to support andempower families. Work is donecollaboratively with families to identify:

t the family’s goalst the strengths/challenges to reaching

these goalst realistic means for achieving them

Training provided by the National ResourceCenter for Family Centered Practice devel-ops the ability of many groups, i.e., Commu-nity Action, Head Start, JOBS programs,county extension, teachers, communityhealth nurses, and family support workers toprovide family centered practice.

Upcoming Family Development Specialist Certification Classes (These are eight-daycertification classes)

September 29-October 1, October 3-5, December 2 & 3, 1999 Des Moines, IowaMay 24-27, June 21-24, 1999 Bismarck, North DakotaSeptember 22-24, October 20-22, December 8 & 9, 1999 Rockford, IllinoisFall 1999 Chicago, IllinoisMay 19-21, June 9-11, June 30 & July 1, 1999 Indianapolis, IndianaJuly 28-30, August 11-13, September 9 & 10, 1999 Indianapolis, IndianaJune 21-24, September 27-30, 1999 New Brunswick, New Jersey

Other possible summer and fall locations: Kansas and California. If you would like moreinformation on any of these classes, or would like to set up a training at your agency pleasecontact Sarah Nash, National Resource Center for Family Centered Practice, TheUniversity of Iowa, School of Social Work, 100 Oakdale Campus, Room W206 OH, IowaCity, IA 52242-5000; Phone: (319) 335-4965 Fax: (319) 335-4964; email: [email protected].


Materials available fromthe National Resource Center for Family Centered Practice

PRINTED MATERIALS

AGENCY-UNIVERSITY COLLABORA-TION IN PREPARING FAMILY PRESER-VATION PRACTITIONERS(1992) $6.00This collection of papers from the Second Uni-versity Educators Conference on Family Pres-ervation explores issues on the effective rela-tionship between family preservation practiceand academic training.

ANNOTATED BIBLIOGRAPHY: FAM-ILY CONTINUITY (1993) $5.00This publication, the result of a collaboration ofthe National Foster Care Resource Center, andThe National Resource Center on Family BasedServices, provides annotations of resources fo-cused on "Family Continuity," a new paradigmfor permanency planning for the 1990's.

BEYOND THE BUZZWORDS: KEY PRIN-CIPLES IN EFFECTIVE FRONTLINEPRACTICE (1994) $4.00This paper, by leading advocates and practitio-ners of family centered services, examines thepractice literature across relevant disciplines, todefine and explain the core principles of familycentered practice.

CHARTING A COURSE: ASSESSING ACOMMUNITY'S STRENGTHS ANDNEEDS (1993) $4.00This resource brief from the National Centerfor Service Integration addresses the basic com-ponents of an effective community assessment.

CHILDREN, FAMILIES, AND COMMU-NITIES—A NEW APPROACH TO SOCIALSERVICES (1994) $8.00This publication from the Chapin Hall Centerfor Children presents a framework for commu-nity-based service systems that includes andbuilds upon community networks of support,community institutions, and more formal ser-vice providers.

CHILDREN, FAMILIES, AND COMMU-NITIES: EARLY LESSONS FROM A NEWAPPROACH TO SOCIAL SERVICES(1995) $5.00This is a street level view of the experience ofimplementing a system of comprehensive com-munity-based services. Another report in aseries on the Chicago Community Trust dem-onstration.

CHRONIC NEGLECT IN PERSPECTIVE:A STUDY OF CHRONICALLY NEGLECT-ING FAMILIES IN A LARGE METRO-POLITAN COUNTY:EXEC SUMMARY: (1990) no chargeFINAL REPORT: (1990) $15.00A research study examining three groups offamilies referred for child neglect: chronic ne-glect, new neglect, and unconfirmed neglect.The report presents descriptive data about thesegroups of families, changes over time and differ-ences between the three groups. The study wasconducted in Allegheny County, PA, and fundedby OHDS and the Vira I. Heinz Endowment.

COMMUNITY RESPONSE TOHOMELESSNESS: EVALUATION OFTHE HACAP TRANSITIONAL HOUS-ING PROGRAMEXEC SUMMARY (1996) no chargeFINAL REPORT (1996) $8.00An evaluation of a HUD-funded demonstrationproject of the Hawkeye Area Community Ac-tion Program (1990-1995). This project pro-vided transitional housing and supportive ser-vices for homeless families with the objectivesof achieving housing stability and economic self-sufficiency. Data include background informa-tion from participants obtained through struc-tured interviews, and self-sufficiency measuresat intake, termination, and six month follow-upto evaluate progress in housing, job, education,and income stability.

COMMUNITY SOCIAL WORK: A PARA-DIGM FOR CHANGE (1988) $7.50This book is a collective product of a workgroup in Great Britain set up to articulate corecharacteristics of community social work.

COST EFFECTIVENESS OF FAMILY-BASED SERVICES (1995) $3.00This paper describes the data and cost calcula-tion methods used to determine cost effective-ness in a study of three family preservationprograms.

CREATING CULTURES OF FAMILY SUP-PORT AND PRESERVATION: FOURCASE STUDIES (1993) $3.50This document explores issues relevant to theeffective integration of family preservation andfamily support programs called for in new fed-eral legislation.

DEVELOPING LINKAGES BETWEENFAMILY SUPPORT & FAMILY PRESER-VATION SERVICES: A BRIEFING PA-PER FOR PLANNERS, PROVIDERS, ANDPRACTITIONERS (1994) $2.00This working paper explores the connections inpolicy, program design, and practice needed toenhance the chances for success of linked pro-grams.

EMPOWERING FAMILIES: PAPERSFROM THE FOURTH ANNUAL CON-FERENCE ON FAMILY-BASED SERVICES(1990) $10.00A collection representing the second publishedproceedings from the annual Empowering Fami-lies Conference sponsored by the National As-sociation for Family Based Services. Majorsections address Programs and Practices, Pro-gram Issues, and Practice Issues—reflecting newand continuing developments in family-basedservices.

EMPOWERING FAMILIES: PAPERSFROM THE FIFTH ANNUAL CONFER-ENCE ON FAMILY-BASED SERVICES(1991) $10.00A collection representing the third publishedproceedings from the annual Empowering Fami-lies Conference sponsored by the National As-sociation for Family Based Services. Five majorsections—Training and Education, Research,Practice Issues, Program and Practice Issues, andProgram and Policy Issues.

EMPOWERING FAMILIES: PAPERSFROM THE SIXTH ANNUAL CONFER-ENCE ON FAMILY-BASED SERVICES(1992) $10.00A collection representing the fourth publishedproceedings from the annual Empowering Fami-lies Conference sponsored by the National As-sociation for Family Based Services. Majorsections address Diversity, Research, and Ex-pansion in family-based services.

EMPOWERING FAMILIES: PAPERSFROM THE SEVENTH ANNUAL CON-FERENCE ON FAMILY-BASED SERVICES(1993) $10.00This is the latest collection of papers from the NAFBS conference in Ft. Lauderdale. Chap-ters address family empowerment and systemschange, child protection and family preserva-tion, determining outcomes for community-based services, and wraparound services for SEDyouth.


materials available______________________________________________________________________

EMPOWERING FAMILIES: PAPERSFROM THE EIGHTH ANNUAL CON-FERENCE ON FAMILY-BASED SER-VICES (1994) $10.00This collection presents the best from thenational conference. Key issues include reunifi-cation practice, family-centered residential treat-ment, culture and therapy, and a variety ofresearch and evaluation issues.

EMPOWERMENT EVALUATION:KNOWLEDGE AND TOOLS FOR SELF-ASSESSMENT AND ACCOUNTABILITY(1996) $27.00This volume derives from a conference of theAmerican Evaluation Association. It addressesthe concepts, methods, and tools needed tointegrate evaluation into the everyday practicesof running programs.

EVALUATING FAMILY BASED SER-VICES (1995) $35.00Major researchers in the field of family basedservices contribute chapters on all aspects of theevaluation process appropriate to a variety ofprogram models.

FACTORS CONTRIBUTING TO SUC-CESS AND FAILURE IN FAMILY-BASEDCHILD WELFARE SERVICES:EXEC SUMMARY (1988) $2.50FINAL REPORT (1988) $15.00(Includes the Executive Summary)Summary and final report of a 2-year federallyfunded study analyzing social worker charac-teristics, family characteristics, services provided,outcomes, and the relationship between thesefactors in eleven family-based placement pre-vention programs.

FAMILY-BASED JOB DESCRIPTIONS(1986) $7.50A compilation of job descriptions for family-based service workers (including social work-ers, supervisors, administrators, family thera-pists and paraprofessionals) which are currentlyin use by selected public and private family-based programs throughout the country.

FAMILY-BASED SERVICES FOR JUVE-NILE OFFENDERS (1990) no chargeAn analysis of family characteristics, servicecharacteristics, and case outcomes of familiesreferred for status offenses or juvenile delin-quency in eight family-based placement preven-tion programs. In Children and Youth Services,Vol. 12, No. 3, 1990.

FAMILY-CENTERED SERVICES: AHANDBOOK FOR PRACTITIONERS(1994) $15.00This completely revised edition of the Practitio-ners Handbook addresses core issues in familycentered practice, from assessment through ter-minating services. Also included are a series ofchapters on various topics such as neglect, sub-stance abuse, sexual abuse, and others.

FAMILY FUNCTIONING OF NEGLECT-FUL FAMILIES: FAMILY ASSESSMENTMANUAL (1994) $5.00This manual describes the methodology andincludes the structured interview and all stan-dardized instruments administered in thisNCCAN-funded research study.

FAMILY FUNCTIONING OF NEGLECT-FUL FAMILIES: FINAL REPORT(1994) $8.00Final report from NCCAN-funded researchstudy on family functioning and child neglect,conducted by the NRC/FBS in collaborationwith the Northwest Indian Child Welfare Asso-ciation. The study is based on structured inter-views with neglecting and comparison familiesin Indian and non-Indian samples in two states.

FAMILY GROUP CONFERENCE(1996) $20.00This volume offers a complete presentation ofthe Family Group Conference, the extendedfamily network child protection model fromNew Zealand.

GUIDE FOR PLANNING: MAKINGSTRATEGIC USE OF THE FAMILY PRES-ERVATION AND SUPPORT SERVICESPROGRAM (1994) $8.00This document presents a comprehensive frame-work for implementing the federal family pres-ervation and support services program.

HEAD START OUTCOMES FOR HOME-LESS FAMILIES & CHILDREN: EVALU-ATION OF THE HACAP HOMELESSHEAD START DEMONSTRATIONPROJECT (1996) $6.00This study reports findings of a transitionalhousing program for homeless women and chil-dren.

HOME-BASED SERVICES FORTROUBLED CHILDREN(1995) $35.00 [includes s/h]This collection situates home-based serviceswithin the system of child welfare services. Itexamines the role of family preservation, familyresource programs, family-centered interven-tions for juveniles, issues in the purchase ofservices, and others.

INTENSIVE FAMILY PRESERVATIONSERVICES RESEARCH CONFERENCE;CLEVELAND, OHIO—SEPTEMBER 25-26,1989; FINAL REPORT(1990) no chargeFinal report of a two-day conference on familypreservation services research, cosponsored bythe Bellefaire Jewish Children's Bureau, theMandel School of Applied Social Sciences atCase Western Reserve University, and the Treu-Mart Fund. The final report includes thehistory and definition of family preservation,implementation in child welfare, juvenile jus-tice and mental health systems, review of exist-ing research and recommendations for futureresearch. The brief report focuses exclusivelyon needed research in the area.

KEY CHARACTERISTICS AND FEA-TURES OF COMMUNITY-BASED FAM-ILY SUPPORT PROGRAMS (1995) $6.00This is a thorough review of issues determiningthe success of Family Support programs.

KNOW YOUR COMMUNITY: A STEP-BY-STEP GUIDE TO COMMUNITYNEEDS AND RESOURCES ASSESSMENT(1995) $28.00This is a manual and tool kit for conducting acommunity needs and capacities assessment.The price includes a computer diskette contain-ing sample forms. Please indicate Mac or DOSversion.

LENGTH OF SERVICE & COST EFFEC-TIVENESS IN THREE INTENSIVE FAM-ILY SERVICE PROGRAMSSUMMARY REPORT (1996) $2.00FINAL REPORT (1996) $17.00Report of an experimental research study test-ing the effect of length of service on case out-comes and cost-effectiveness in three familybased treatment programs.

LINKING FAMILY SUPPORT ANDEARLY CHILDHOOD PROGRAMS: IS-SUES, EXPERIENCES, OPPORTUNITIES(1995) $6.00This monograph examines opportunities forfamily support in child care settings.

MAKING A DIFFERENCE: MOVING TOOUTCOME BASED ACCOUNTABILITYFOR COMPREHENSIVE SERVICE RE-FORMS (1994) $4.00This resource brief from the National Centerfor Service Integration presents the basic com-ponents of a program level outcomes basedaccountability system.


materials available_______________________________________________________________________

MAKING IT SIMPLER: STREAMLININGINTAKE AND ELIGIBILITY SYSTEMS(1993) $4.00This working paper from the National Centerfor Service Integration outlines a process forintegrating intake and eligibility systems acrossagencies.

MAKING WELFARE WORK: A FAMILYAPPROACH (1992) $3.15This is an account of Iowa's Family Develop-ment and self-sufficiency Demonstration GrantProgram (FaDDS). It describes a family supportapproach to welfare reform.

MANAGING CHANGE THROUGH IN-NOVATION (1998) $18.00This manual treats the dynamics of the changeprocess in a variety of social services settings.

MAPPING CHANGE AND INNOVA-TION (1996) $25.00This companion workbook to Managing ChangeThrough Innovation addresses major issues re-lated to managing change in any social organiza-tion and guides readers to develop a plannedapproach specific to their particular circum-stances.

MULTISYSTEMIC THERAPY: USINGHOME-BASED SERVICES: A CLINI-CALLY EFFECTIVE AND COST EFFEC-TIVE STRATEGY FOR TREATING SERI-OUS CLINICAL PROBLEMS IN YOUTH(1996) no chargeThis brief manual provides an overview of themultisystemic approach to treating serious anti-social behavior in adolescents and theirmultineed families. Dr. Henggeler outlines thefocus of the approach on the family, the youth'speer group, the schools, and the individual youth,along with the structure of the family preserva-tion program, and the research which docu-ments the program's effectiveness.

NEW APPROACHES TO EVALUATINGCOMMUNITY INITIATIVES: CON-CEPTS, METHODS, AND CONTEXTS(1995) $12.00Evaluating coordinated service interventions isa complex process. This volume examines a setof key issues related to evaluating communityinitiatives.

POST ADOPTION FAMILY THERAPY(PAFT): A PRACTICE MANUAL; OregonChildren's Services Division(1990) $3.00Discusses the conception, development andimplementation of the PAFT project includingpositive research findings for 50 at-risk families.Part two describes therapeutic challenges of

adoption, intervention techniques, and the treat-ment model developed by the project.

POST ADOPTION RESOURCES FORTRAINING, NETWORKING, ANDEVALUATION SERVICES (PARTNERS):WORKING WITH SPECIAL NEEDSADOPTIVE FAMILIES IN STRESS; FourOaks, Inc., Cedar Rapids, Iowa(1992) $4.25Information about the PARTNERS model foradoptive families with special needs children.Includes a description of support services, screen-ing, assessment, treatment planning, treatmentand termination phases of the project, and de-scriptive statistics of the 39 families served. Parttwo describes therapeutic challenges of adop-tion.

PREVENTING CHILD ABUSE AND NE-GLECT THROUGH PARENT EDUCA-TION (1997) $25.95Based on research of 25 parenting programs, thisvolume outlines how to develop and evaluateparent education programming to help preventchild maltreatment.

PUBLIC-PRIVATE PROVISION OF FAM-ILY-BASED SERVICES: RESEARCHFINDINGS (1989) no chargeA paper presented at the NAFBS Third AnnualEmpowering Families Conference (Charlotte,NC) discussing research findings on differencesbetween family-based services provided by pub-lic and private providers.

QUALITY IMPROVEMENT AND EVALU-ATION IN CHILD AND FAMILY SER-VICES: MANAGING INTO THE NEXTCENTURY(1996) $22.90This handbook describes how agency execu-tives can address the changing world of servicesfor children and families by practically applyingquality improvement theory to assess and im-prove programs and services.

RACIAL INEQUALITY AND CHILD NE-GLECT: FINDINGS IN A METROPOLI-TAN AREA (1993) no chargeDespite contradictory evidence, child neglect isbelieved to occur with greater frequency amongAfrican-Americans for a variety of reasons. Thisarticle describes racial differences among 182families referred for neglect in a large metro-politan area.

REALIZING A VISION (1996) $5.00This working paper positions the progressivechildren and family services reform agendawithin a complex welter of change, and it posesa provocative answer to the question: "Wheredo we go from here?"

REINVENTING HUMAN SERVICES:COMMUNITY- AND FAMILY-CEN-TERED PRACTICE (1995) $25.00This collection of articles explores aspects ofthe move towards a community-based servicesystem. The book explores social work, eco-nomic development, school-linked services, andcommunity policing. Crossing these differentservice sectors is a common understanding ofcommunity- and family-centered practice.

REPARE: REASONABLE EFFORTS TOPERMANENCY THROUGH ADOP-TION AND REUNIFICATION ENDEAV-ORSExecutive Summary (1996) $4.00Final Report (1996) $17.00REPARE created a family based approach toresidential treatment characterized by reducedlength of stay, integration of family preserva-tion and family support principles, and com-munity based aftercare services to expeditepermanency. The Final Report describes theconceptual approach and project design, les-sons learned from implementation, and evalu-ation results (including instruments). [Fundedby ACYF, Grant #90CW1072.]

RISING ABOVE GANGS AND DRUGS:HOW TO START A COMMUNITY REC-LAMATION PROJECT (1990) $2.00This is a how-to manual for building and sus-taining a community collaboration focused onyouth issues.

THE SELF-SUFFICIENCY PROJECT: FI-NAL REPORT (1992) $5.00Final evaluation report of a federally-fundeddemonstration project in rural Oregon servingfamilies experiencing recurring neglect. In-cludes background and description of project,findings from group and single subject analy-ses, and evaluation instruments. (See The Self-Sufficiency Project: Practice Manual below.)

THE SELF-SUFFICIENCY PROJECT:PRACTICE MANUAL (1992) $3.15This manual describes a treatment program forworking with families experiencing recurringneglect, based on a federally-funded demon-stration project in rural Oregon. Includesproject philosophy and design, staffing, discus-sion, and descriptive case studies (See The Self-Sufficiency Project: Final Report above.)

SOURCEBOOK: ANNOTATED RE-SOURCES FOR FAMILY BASED SER-VICE PRACTICE: 4th Edition(1993) $5.00Descriptions and ordering information for se-lected resources on: family therapy, FBS theoryand practice, research and evaluation, legalissues, family-based services management, and


materials available_______________________________________________________________________

training. Lists FBS service associations andprogram directories. Includes many unpub-lished materials prepared by social service de-partments, not generally available in libraries,which can be ordered from those agencies.

STATE LEGISLATIVE LEADERS: KEYSTO EFFECTIVE LEGISLATION FORCHILDREN & FAMILIES: A REPORT(1995) $1.00This is the report of an eye-opening survey onhow far children and family advocates have togo towards building a sustained legislativeagenda.

STRENGTHENING FAMILIES & NEIGH-BORHOODS: A COMMUNITY-CEN-TERED APPROACH(1995) $8.00This is the final report of the "Patch" demon-stration project, a model for community-cen-tered social work practice that is now generat-ing national attention.

STRENGTHENING HIGH-RISK FAMI-LIES (A HANDBOOK FOR PRACTITIO-NERS); Authors: Lisa Kaplan and Judith L.Girard (1994) $35.00This accessible handbook on family-centeredpractice addresses the range of issues to be con-sidered in working with high-risk families. Prac-tice strategies are set within the context of thedevelopment of family preservation services.

THREE MODELS OF FAMILY-CEN-TERED PLACEMENT PREVENTION SER-VICES (1990) no chargeAn analysis that defines and compares family-centered services by identifying three modelswhose primary goal is tertiary prevention, theprevention of out-of-home placement of chil-dren from seriously troubled families, or reuni-fication once placement has occurred. Alsoexamines data from 11 family-centered place-ment prevention programs that further speci-fies and compares these models. Reprinted withpermission from Child Welfare, Vol. LXIX: No.1, (Jan/Feb 1990).

TOGETHER WE CAN: A GUIDE FORCRAFTING A PROFAMILY SYSTEM OFEDUCATION AND HUMAN SERVICES(1993) no chargeThis is a guidebook to a five stage process forcreating and sustaining community collabora-tions.

TO LOVE A CHILD (1992) no chargeThis book describes the many ways in whichresponsible and caring adults can contribute tothe lives of children: mentoring adoption, fam-ily foster care, kinship care and others.

TRAINING MANUAL FOR FOSTER PAR-ENTS (1990) $12.00Created by Dr. Patricia Minuchin at FamilyStudies in New York, the Manual includes atheoretical section describing the rationale, goals,themes and skills, and a training section thatdescribes eight sessions. The activities of thesessions are experiential, including role playing,small groups, simulated cases, and discussions.The sessions are focused on understanding fami-lies and on exploring attitudes about families, onthe skills of making and keeping contact withbiological families, and on the liaison betweenfoster parents and professional workers as theyfunction in the foster care network.

TRAINING RESOURCES: FAMILY CON-TINUITY (1993) $2.00A bibliography of training resources of theNational Resource Center for Family CenteredPractice, The National Foster Care ResourceCenter, The National Resource Center for Spe-cial Needs Adoption, and other organizations.

WHO SHOULD KNOW WHAT? CONFI-DENTIALITY AND INFORMATIONSHARING IN SERVICE INTEGRATION(1993) $4.00Analyzes issues pertaining to confidentiality incollaborative projects. The paper includes achecklist of key questions.

WISE COUNSEL: REDEFINING THEROLE OF CONSUMERS, PROFESSION-ALS, AND COMMUNITY WORKERS INTHE HELPING PROCESS; RESOURCEBRIEF #8 (1998) $8.00This collection of readings examines the needfor and benefit of changing relationships be-tween professionals, community workers andconsumer needs to implement true system re-form and improve results.

For a detailed description of audiovisual materials,see page 39.


REQUEST FOR NRC/FCP INFORMATION & ORDER FORM -- Spring, 1999

PAYMENT MUST ACCOMPANY ORDERPlease make checks/money orders payable to the National Resource CenterPurchase orders accepted. (Sorry, we cannot accept credit cards.) Shippinghandling--all orders $5.00 minimum (for over 10 items, please add $.25 foeach additional item ordered).

Send orders to: The National Resource Center for Family Centered PracticeThe University of Iowa, School of Social Work, 100 Oakdale Campus #W20OH, Iowa City, Iowa 52242-5000. Phone (319) 335-4965.

* cost per copy for multiple copies** no charge for one copy

DATE______________________________________

S NAME______________________________________HI ADDRESS__________________________________P

___________________________________________TO CITY/STATE/ZIP_____________________________

PHONE NUMBER (____)_______________________

TITLE/DESCRIPTION PRICE QTY TOTALAgency-University Collaboration: 2nd Univ Educators' Conf Proceedings (1992) $ 6.00 _____ ________Annotated Bibliography: Family Continuity (1993) 5.00 _____ ________Beyond the Buzzwords: Key Principles in Effective Frontline Practice (1994) 4.00 _____ ________Charting a Course: Assessing a Community's Strengths & Needs (1993) 4.00 _____ ________Children, Families, and Communities--A New Approach to Social Services (1994) 8.00 _____ ________Children, Families, & Communities: Early Lessons From a New Approach to Social Svcs (1995) 5.00 _____ ________Chronic Neglect in Perspective: Executive Summary (1990) [$.30*] nc ** _____ ________Chronic Neglect in Perspective: Final Report (1990) 15.00 _____ ________Community Response to Homelessness: Evaluation of the HACAP: Final Report (1996) 8.00 _____ ________Community Response to Homelessness: Evaluation of the HACAP: Executive Summary (1996) nc ** _____ ________Community Social Work: A Paradigm for Change (1988) 7.50 _____ ________Cost Effectiveness of Family Based Services (1995) 3.00 _____ ________Creating Cultures of Family Support and Preservation: Four Case Studies (1993) 3.50 _____ ________Developing Linkages Between Family Support & Fam Pres Services (1994) 2.00 _____ ________Empowering Families: Papers 4th Annual Conference on FBS (1990) 10.00 _____ ________Empowering Families: Papers 5th Annual Conference on FBS (1991) 10.00 _____ ________Empowering Families: Papers 6th Annual Conference on FBS (1992) 10.00 _____ ________Empowering Families: Papers 7th Annual Conference on FBS (1993) 10.00 _____ ________Empowering Families: Papers 8th Annual Conference on FBS (1994) 10.00 _____ ________Empowerment Evaluation: Knowledge & Tools for Self-Assessment & Accountability (1996) 27.00 _____ ________Evaluating Family Based Services (1995) 35.00 _____ ________Factors Contributing to Success & Failure in FBS: Executive Summary (1988) 2.50 _____ ________Factors Contributing to Success & Failure in FBS: Final Report (Includes exec sum) [1988] 15.00 _____ ________Family Based Job Descriptions (1986) 7.50 _____ ________Family-Based Services for Juvenile Offenders (1990) [$.50*] nc ** _____ ________Family-Centered Services: A Handbook for Practitioners (1994) 15.00 _____ ________Family Functioning of Neglectful Families: Family Assessment Manual (1994) 5.00 _____ ________Family Functioning of Neglectful Families: Final Report (1994) 8.00 _____ ________Family Group Conferences in Child Abuse and Neglect Cases (1996) 20.00 _____ ________Guide for Planning: Making Strategic Use of Fam Pres & Support Services Program (1994) 8.00 _____ ________Head Start Outcomes for Homeless Families & Children: Evaluation of the HACAP (1996) 6.00 _____ ________Home-Based Services for Troubled Children (1995) [includes shipping/handling] 35.00 _____ ________Intensive Fam Pres Svcs Research Conf, Cleveland, OH; (1990) Final Report [$2.25*] nc ** _____ ________Key Characteristics and Features of Community-Based Family Support Programs (1995) 6.00 _____ ________Know Your Community: A Step-by-Step Guide to Community Needs . . . (1995) 28.00 _____ ________Length of Service & Cost Effectiveness in Three Intensive Fam Svc Progs (1996) Exec Summary 2.00 _____ ________Length of Service & Cost Effectiveness in Three Intensive Fam Svc Progs (1996) Final Report 17.00 _____ ________Linking Family Support and Early Childhood Programs: Issues, Experiences, Opportunities (1995) 6.00 _____ ________Making a Difference: Moving to Outcome Based Accountability for Comprehensive Service (1994) 4.00 _____ ________Making It Simpler: Streamlining Intake and Eligibility Systems (1993) 4.00 _____ ________Making Welfare Work: A Family Approach (1992) 3.15 _____ ________Managing Change Through Innovation (1998) 18.00 _____ ________Mapping Change and Innovation (1996) 25.00 _____ ________Multisystemic Therapy Using Home-Based Services: A Clinically Effective ... (1996) [$.80*] nc ** _____ ________New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts (1995) 12.00 _____ ________Post Adoption Family Therapy (PAFT): A Practice Manual (1990) 3.00 _____ ________Post Adoption: Resources for Training ... PARTNERS--Four Oaks (1992) 4.25 _____ ________Preventing Child Abuse & Neglect Through Parent Education (1997) 25.95 _____ ________Public-Private Provision of Family-Based Services: Research Findings (1989) [$.50*] nc ** _____ ________Quality Improvement & Evaluation in Child & Family Services: Managing Into the Next Century (1996) 22.90 _____ ________Racial Inequality and Child Neglect: Findings in Metro Area (1993) [$.50*] nc ** _____ ________

continued on next page

materials available/order form______________________________________________________________


materials available/order form______________________________________________________________

AUDIOVISUAL MATERIALS

CIRCULARITY AND SEQUENCES OF BEHAVIOR (1992) (*includes s/h) $25.00*This 30-minute training videotape describes the family systems concepts of circularity and sequences of behavior, and thendemonstrates how the concepts are utilized in a child protection interview with a family where inadequate supervision ofyoung children is an issue. Useful for training family-centered practitioners in any human services program.

FAMILY-BASED SERVICES: A SPECIAL PRESENTATION (1990) $80.00*(*Plus $5.00 shipping)Videotape: 24 minutes. A lively introduction to the history, philosophy, and practice of family-based services featuringinterviews with policy-makers, agency administrators, family-based service workers and families who have received services.For use by advocacy and civic groups, boards of directors, legislators and social service workers. A video guide accompaniesthe taped presentation.

TITLE/DESCRIPTION PRICE QTY TOTAL

Realizing a Vision (1996) 5.00 _____ ________Reinventing Human Services: Community- & Family-Centered Practice (1995) 25.00 _____ ________REPARE: Reasonable Efforts to Permanency Planning Through Adoption...(1996) Exec Sum 4 .00 _____ ________REPARE: Reasonable Efforts to Permanency Planning Through Adoption...(1996) Final Report 17.00 _____ ________Rising Above Gangs and Drugs: How to Start a Community Reclamation Project (1990) 2.00 _____ ________Self-Sufficiency Project: ___Final Report--$5.00/___Practice Manual--$3.15 (1992) 5.00 or 3.15 _____ ________Sourcebook: Annotated Resources for FBS Practice--4th Edition (1993) 5.00 _____ ________State Legislative Leaders: Keys to Effective Legislation (1995) 1.00 _____ ________Strengthening Families & Neighborhoods: A Community-Centered Approach (1995) 8.00 _____ ________Strengthening High-Risk Families: A Handbook for Practitioners (1994) 35.00 _____ ________Three Models of Family Centered Placement Prevention Services (1990) [$.50*] nc ** _____ ________Together We Can: A Guide for Crafting a Profamily System of Education & Human Svcs (1993) nc _____ ________To Love a Child (A complete guide to adoption, foster parenting, etc.) (1992) nc _____ ________Training Manual for Foster Parents (1990) 12.00 _____ ________Training Resources: Family Continuity (1993) 2.00 _____ ________Who Should Know What? Confidentiality and Information Sharing in Service Integration (1993) 4.00 _____ ________Wise Counsel: Redefining the Role of Consumers, Professionals & Comm Workers ... (1998) 8.00 _____ ________

AUDIOVISUAL MATERIALS:

Video Tapes--Circularity & Sequences of Behavior (1992) [price includes s/h] $25.00 _____ ________Family-Based Services: A Special Presentation (1990) [add $5.00 for s/h] $80.00 _____ ________

Subtotal _____ ________Shipping/Handling ($5.00 minimum) _____ ________

TOTAL _____ $________


National Resource Center for Family Centered PracticeThe University of Iowa School of Social Work100 Oakdale Campus #W206 OHIowa City, IA 52242-5000

ADDRESS SERVICE REQUESTED Non Profit OrganizationU.S. Postage

PAIDPermit no. 45Iowa City, IA

THE PREVENTION REPORT

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Documents

The National Resource Center for Family ... - Marty Beyerby: Marty Beyer, Ph.D. Family visits with children in out-of-home care are an underutilized service which, if carefully orchestrated,